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在哈瓦萨转诊医院接受随访的成年高血压患者中抗高血压药物依从性的决定因素:一项病例对照研究。

Determinants of adherence to anti-hypertensive medications among adult hypertensive patients on follow-up in Hawassa Referral Hospital: A case-control study.

作者信息

Getenet Atsede, Tesfa Mulugeta, Ferede Aster, Molla Yalew

机构信息

Department of Pharmacy, Debre Markos Referral Hospital, Debre Markos, Ethiopia.

Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.

出版信息

JRSM Cardiovasc Dis. 2019 Dec 13;8:2048004019892758. doi: 10.1177/2048004019892758. eCollection 2019 Jan-Dec.

Abstract

INTRODUCTION

Hypertension is a global challenge which accounts for high morbidity and mortality rates in the world. The availability of effective anti-hypertensive medications does not result in a good outcome in controlling blood pressure which points towards poor adherence. Thus, this study was conducted to assess the determinants of adherence to anti-hypertensive medication among hypertensive patients on follow-up in Hawassa Referral Hospital.

METHODS

Institution-based case-control study was conducted on a sample of 289 clients from February to May 2018. Census was conducted on 1600 clients to select cases and controls. Then, systematic random sampling was used to select study subjects, and adherence was measured by Morisky medication adherence scale. The associations of variables were analyzed using bivariable followed by multivariable logistic regression analyses.

RESULTS

The respondent's adherence to medication was found to be 67% as measured by Morisky medication adherence scale. The multivariate logistic regression analysis showed that medication adherence was found to be better in younger age (<45) (AOR = 3.8), clients living in urban areas (AOR = 6.84), those clients who had good knowledge (AOR = 3.13), those with no co-morbidities (AOR = 3.14) and patients who controlled their blood pressure (<140/90) (AOR = 2.35).

CONCLUSIONS

The rate of medication adherence was found to be low, and hence educational interventions focusing on factors promoting adherence and patients' health support should be implemented.

摘要

引言

高血压是一项全球性挑战,在世界范围内导致了高发病率和死亡率。有效的抗高血压药物的可及性并未带来良好的血压控制效果,这表明依从性较差。因此,本研究旨在评估哈瓦萨转诊医院接受随访的高血压患者中抗高血压药物治疗依从性的决定因素。

方法

2018年2月至5月,对289名患者进行了基于机构的病例对照研究。对1600名患者进行普查以选择病例和对照。然后,采用系统随机抽样法选择研究对象,并通过Morisky药物依从性量表测量依从性。使用双变量分析,随后进行多变量逻辑回归分析来分析变量之间的关联。

结果

通过Morisky药物依从性量表测量,发现受访者的药物治疗依从率为67%。多变量逻辑回归分析表明,年龄较小(<45岁)(调整后比值比[AOR]=3.8)、居住在城市地区的患者(AOR=6.84)、知识水平良好的患者(AOR=3.13)、无合并症的患者(AOR=3.14)以及血压得到控制(<140/90)的患者(AOR=2.35)的药物治疗依从性更好。

结论

发现药物治疗依从率较低,因此应实施侧重于促进依从性的因素和患者健康支持的教育干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95d5/6967193/6e55652fef82/10.1177_2048004019892758-fig1.jpg

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