心房颤动患者的心脏药物治疗依从性：一项初步研究。
Adherence to Cardiac Medications in Patients With Atrial Fibrillation: A Pilot Study.
机构信息
Sydney Nursing School, University of Sydney, Sydney, NSW, Australia; Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia; Nepean Hospital, Sydney, NSW, Australia.
Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia; Heart Research Institute, Sydney, NSW, Australia.
出版信息
Heart Lung Circ. 2020 Jul;29(7):e131-e139. doi: 10.1016/j.hlc.2019.11.012. Epub 2019 Dec 17.
BACKGROUND
Non-adherence to medications is common in patients with atrial fibrillation (AF), increasing the risk of stroke, co-morbidities, and AF symptoms. Understanding factors influencing medication adherence is important in providing holistic care to patients with AF. This study aimed to explore medication adherence in patients with AF, and explore associations with health literacy, cognition, or AF knowledge.
METHODS
A single-centre pilot study, using survey questionnaires and open questions. Patients with a primary cardiac diagnosis, with AF as primary or secondary diagnosis, were eligible for recruitment. During hospitalisation, adherence to cardiac medications was assessed using the Basel Assessment of Adherence to Immunosuppressive Medication Scale (BAASIS). Health literacy, cognition, and AF knowledge were assessed through validated questionnaires. Facilitators and barriers for medication adherence were obtained through open-ended question and coded using a content analysis approach.
RESULTS
Fifty-four (54) patients were recruited (61% male, mean age 71±11). Twenty-two (22) participants (41%) were classified as non-adherent using the BAASIS; with a corresponding self-reported adherence of 87.7% in non-adherent participants compared to 97.8% in adherent participants. No associations were identified between medication adherence and cognition, health literacy, or AF knowledge. Facilitators for adherence included external assistance, routines, and medication knowledge, and these were reported by both adherent and non-adherent participants. Non-adherent participants reported more barriers including medication concerns, forgetfulness, and lifestyle factors.
CONCLUSIONS
Large numbers of AF patients are likely to be non-adherent to medications. Medication adherence is influenced by multiple factors, individual to each patient. Diverse strategies are required to ensure adherence to cardiac medications.
背景
在心房颤动（AF）患者中，不遵医嘱服药很常见，这会增加中风、合并症和 AF 症状的风险。了解影响药物依从性的因素对于为 AF 患者提供全面护理非常重要。本研究旨在探讨 AF 患者的药物依从性，并探讨与健康素养、认知或 AF 知识的关联。
方法
这是一项单中心试点研究，使用问卷调查和开放式问题。符合招募条件的患者具有原发性心脏诊断，AF 为原发性或继发性诊断。在住院期间，使用巴塞尔评估免疫抑制药物依从性量表（BAASIS）评估心脏药物的依从性。通过经过验证的问卷评估健康素养、认知和 AF 知识。通过开放式问题获得药物依从性的促进因素和障碍，并使用内容分析方法进行编码。
结果
共招募了 54 名（61%为男性，平均年龄 71±11 岁）患者。使用 BAASIS，22 名（22%）参与者被归类为不依从；不依从参与者的自我报告依从率为 87.7%，而依从参与者的自我报告依从率为 97.8%。药物依从性与认知、健康素养或 AF 知识之间没有关联。依从性的促进因素包括外部协助、常规和药物知识，且这些因素在依从和不依从的参与者中均有报告。不依从的参与者报告了更多的障碍，包括药物顾虑、健忘和生活方式因素。
结论
大量 AF 患者可能不遵医嘱服药。药物依从性受多种因素影响，每个患者各不相同。需要采取多种策略来确保心脏药物的依从性。
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