低成本提醒包联合病例式健康教育提高高血压患者用药依从性的效果：一项整群随机对照试验
Effectiveness of low-cost reminder package combined with case-based health education to improve hypertensive patients' medication adherence: a clustered randomized controlled trial.
作者信息
Shen Ying, Wang Taotao, Gao Min, Zhu Xiaorou, Zhang Xing, He Chao, Li Yindong, Sun Xinying
机构信息
School of Public Health, Peking University, Beijing, People's Republic of China.
Department of Health Education, Shunyi Center for Disease Control and Prevention, Beijing, People's Republic of China.
出版信息
Patient Prefer Adherence. 2019 Jul 10;13:1083-1092. doi: 10.2147/PPA.S194667. eCollection 2019.
PURPOSE
Medication adherence (MA) is a key factor for hypertensive patients' blood pressure control and forgetfulness is one of the main reasons that cause medication non-adherence. If effective, low-cost reminder package (LCRP) has great potentials for large-scale promotion. Therefore, this study aims to evaluate the effectiveness of combining LCRP and health education to improve MA among hypertensive patients.
PATIENTS AND METHODS
A clustered randomized controlled trial was performed in Beijing. A total of 518 hypertensive patients recruited from 8 community health care centers were randomized to receive LCRP combined with case-based health education or usual care. Randomization was performed at community level. Multilevel modeling was used to evaluate the study effect.
RESULTS
MA scores did not differ significantly at baseline between the intervention group and the control group. The results of multilevel modeling indicated that MA scores increased more in the intervention group, and the intervention effect on MA was 0.287 (95% CI: [0.103, 0.471], =0.002). Patients' systolic blood pressure (SBP) and diastolic blood pressure (DBP) were not improved (SBP: difference=0.536, 95% CI [-3.207, 4.278]; DBP: difference=-0.927, 95% CI [-3.283, 1.428]).
CONCLUSION
LCRP combined with case-based health education could significantly improve hypertensive patients' MA.
目的
药物依从性（MA）是高血压患者血压控制的关键因素，遗忘是导致药物不依从的主要原因之一。如果有效，低成本提醒包（LCRP）具有大规模推广的巨大潜力。因此，本研究旨在评估LCRP与健康教育相结合对提高高血压患者药物依从性的有效性。
患者与方法
在北京进行了一项整群随机对照试验。从8个社区卫生服务中心招募的518例高血压患者被随机分为接受LCRP联合病例健康教育或常规护理。随机分组在社区层面进行。采用多水平模型评估研究效果。
结果
干预组和对照组在基线时的MA评分无显著差异。多水平模型结果表明，干预组的MA评分增加更多，对MA的干预效果为0.287（95%CI：[0.103, 0.471]，P = 0.002）。患者的收缩压（SBP）和舒张压（DBP）未得到改善（SBP：差异 = 0.536，95%CI [-3.207, 4.278]；DBP：差异 = -0.927，95%CI [-3.283, 1.428]）。
结论
LCRP联合病例健康教育可显著提高高血压患者的药物依从性。
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