Qvarnström Miriam, Kahan Thomas, Kieler Helle, Brandt Lena, Hasselström Jan, Wettermark Björn
Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet , Stockholm , Sweden.
Centre for Pharmacoepidemiology, Department of Medicine, Karolinska Institutet , Stockholm , Sweden.
Blood Press. 2019 Oct;28(5):309-316. doi: 10.1080/08037051.2019.1627858. Epub 2019 Jun 17.
To study the differences in attitudes towards hypertension and drug treatment between patients persistent and non-persistent to antihypertensive drug treatment. Cross-sectional study on patients with hypertension treated at 25 primary healthcare centres in Stockholm, Sweden. Questionnaires were sent to the patients 3-12 months after initiation of antihypertensive drug treatment. Persistent medication users, defined as patients with less than 30 days without tablet supply between prescription refills, were compared with non-persistent users by scores from Likert scales: Brief-Illness Perception Questionnaire (Brief IPQ, 0-10) and Beliefs about Medicines Questionnaire (BMQ General, 4-20 and BMQ Specific, 5-25). A total of 711 patients were included in the final analyses (mean age: 62 years; 50% women), of whom 609 (86%) were classified as persistent and 102 (14%) as non-persistent by analyses of their filled prescriptions. Likert scales from the Brief-IPQ showed (all < 0.02) that persistent patients believed that hypertension was a chronic condition (median 6 vs. 4), that hypertension had less consequences on their life (median 2 vs. 3) and that they can prevent cardiovascular disease by taking antihypertensive treatment (median 7 vs. 5). Likert scales from the BMQ General showed (all < 0.02) that persistent patients believed that there are potential benefits from taking the treatment (median 16 vs. 16), and they did not believe that the doctors put too much trust in drugs (median 12 vs. 13). Further, results from the BMQ Specific showed that they believed that the antihypertensive drugs are necessary for them in order to maintain or improve their own health (median 17 vs. 16). Primary healthcare providers should further emphasize the chronicity of hypertension diagnosis and the benefits of treatment, to improve the patients' medication persistence to antihypertensive treatment.
研究坚持和不坚持抗高血压药物治疗的患者对高血压及药物治疗态度的差异。对瑞典斯德哥尔摩25个初级医疗中心接受治疗的高血压患者进行横断面研究。在开始抗高血压药物治疗3至12个月后向患者发送问卷。将持续用药者（定义为两次处方 refill 之间无药片供应少于30天的患者）与非持续用药者通过李克特量表得分进行比较：简短疾病认知问卷（Brief IPQ，0 - 10）和药物信念问卷（BMQ General，4 - 20以及BMQ Specific，5 - 25）。最终分析共纳入711例患者（平均年龄：62岁；50%为女性），通过对其填写的处方分析，其中609例（86%）被归类为持续用药者，102例（14%）为非持续用药者。Brief - IPQ的李克特量表显示（所有P值均<0.02），持续用药患者认为高血压是一种慢性疾病（中位数6 vs. 4），高血压对其生活的影响较小（中位数2 vs. 3），并且他们可以通过服用抗高血压治疗预防心血管疾病（中位数7 vs. 5）。BMQ General的李克特量表显示（所有P值均<0.02），持续用药患者认为服用该治疗有潜在益处（中位数16 vs. 16），并且他们不认为医生过于信赖药物（中位数12 vs. 13）。此外，BMQ Specific的结果显示，他们认为抗高血压药物对维持或改善自身健康是必要的（中位数17 vs. 16）。初级医疗服务提供者应进一步强调高血压诊断的慢性性质及治疗的益处，以提高患者对抗高血压治疗的用药依从性。
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