与不坚持服用抗高血压药或抗高血脂药相关的可改变因素并不相同：印度尼西亚糖尿病患者的一项多中心研究
Modifiable Factors Associated with Non-adherence to Antihypertensive or Antihyperlipidemic Drugs Are Dissimilar: a Multicenter Study Among Patients with Diabetes in Indonesia.
作者信息
Alfian Sofa D, Annisa Nurul, Fajriansyah Fajriansyah, Perwitasari Dyah A, Abdulah Rizky, Hak Eelko, Denig Petra
机构信息
Unit of PharmacoTherapy, -Epidemiology, & -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, the Netherlands.
Faculty of Pharmacy, Department of Pharmacology and Clinical Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia.
出版信息
J Gen Intern Med. 2020 Oct;35(10):2897-2906. doi: 10.1007/s11606-020-05809-y. Epub 2020 Apr 16.
BACKGROUND
To develop targeted and tailored interventions for addressing medication non-adherence, it is important to identify underlying factors.
OBJECTIVE
To identify factors associated with non-adherence as well as subtypes of non-adherence to antihypertensive or antihyperlipidemic drugs among patients with type 2 diabetes in Indonesia.
DESIGN
An observational multicenter cross-sectional survey.
PARTICIPANTS
Patients with type 2 diabetes using either antihypertensive or antihyperlipidemic drugs in four regions in Indonesia.
MAIN MEASURES
Non-adherence and its subtypes of intentional and unintentional non-adherence were assessed using the Medication Adherence Report Scale. Necessity and concern beliefs were assessed with the Beliefs about Medicines Questionnaire. We applied binary and multinomial logistic regression to assess associations of medication beliefs, sociodemographic factors, and clinical-related factors to non-adherence and report odds ratios (OR) with 95% confidence intervals (CI).
KEY RESULTS
Of 571 participating patients (response rate 97%), 45.5% and 52.7% were non-adherent to antihypertensive and antihyperlipidemic drugs, respectively. Older age was associated with non-adherence to antihypertensive drugs (60-69 years) (OR, 5.65; 95% CI, 2.68-11.92), while higher necessity beliefs (OR, 0.92; 95% CI, 0.88-0.95) were associated with less non-adherence. Factors associated with non-adherence to antihyperlipidemic drugs were female gender (OR, 1.84; 95% CI, 1.03-3.27) and higher concern beliefs (OR, 1.10; 95% CI, 1.03-1.18), while higher necessity beliefs (OR, 0.89; 95% CI, 0.83-0.96) were associated with less non-adherence.
CONCLUSIONS
The main factors associated with non-adherence to antihypertensive and antihyperlipidemic drugs are modifiable. In general, beliefs about the necessity of the drug are important but for antihyperlipidemic drugs concerns are important as well. Healthcare providers should pay attention to identify and address medication beliefs during patient counselling.
背景
为制定针对性和个性化的干预措施以解决用药依从性问题，识别潜在因素很重要。
目的
识别印度尼西亚2型糖尿病患者中与抗高血压或抗高血脂药物用药不依从相关的因素以及不依从的亚型。
设计
一项观察性多中心横断面调查。
参与者
印度尼西亚四个地区使用抗高血压或抗高血脂药物的2型糖尿病患者。
主要测量指标
使用用药依从性报告量表评估不依从及其有意和无意不依从的亚型。使用药物信念问卷评估必要性信念和担忧信念。我们应用二元和多项逻辑回归来评估用药信念、社会人口学因素和临床相关因素与不依从之间的关联，并报告比值比（OR）及95%置信区间（CI）。
关键结果
在571名参与患者（应答率97%）中，分别有45.5%和52.7%的患者不依从抗高血压和抗高血脂药物治疗。年龄较大（60 - 69岁）与不依从抗高血压药物治疗相关（OR，5.65；95% CI，2.68 - 11.92），而较高的必要性信念（OR，0.92；95% CI，0.88 - 0.95）与较低的不依从相关。与不依从抗高血脂药物治疗相关的因素是女性（OR，1.84；95% CI，1.03 - 3.27）和较高的担忧信念（OR，1.10；95% CI，1.03 - 1.18），而较高的必要性信念（OR，0.89；95% CI，0.83 - 0.96）与较低的不依从相关。
结论
与不依从抗高血压和抗高血脂药物治疗相关的主要因素是可改变的。一般来说，关于药物必要性的信念很重要，但对于抗高血脂药物，担忧信念也很重要。医疗保健提供者在患者咨询过程中应注意识别和解决用药信念问题。
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