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高血压患者的治疗依从性:一项横断面研究的结果

Treatment adherence among patients with hypertension: findings from a cross-sectional study.

作者信息

Algabbani Fahad M, Algabbani Aljoharah M

机构信息

Family Medicine Department, Prince Sultan Military Medical City (PSMMC), Riyadh, Riyadh Saudi Arabia.

George Mason University, Fairfax, VA USA.

出版信息

Clin Hypertens. 2020 Sep 15;26:18. doi: 10.1186/s40885-020-00151-1. eCollection 2020.

Abstract

BACKGROUND

Hypertension is a major risk factor for cardiovascular disease, which is the leading cause of mortality globally. Patient's adherence to treatment is a cornerstone factor in controlling hypertension and its complications. This study assesses hypertension patients' adherence to treatment and its associated factors.

METHODS

This cross-sectional study conducted in Riyadh, Saudi Arabia. The study targeted outpatients aged ≥18 years who were diagnosed with hypertension. Participants were recruited using a systemic sampling technique. The two main measurements were assessing adherence rate of antihypertensive medications using Morisky scale and identifying predictors of poor medication adherence among hypertensive patients including socio-economic and demographic data, health status, clinic visits, medication side effects, medications availability, and knowledge. Descriptive and logistic regression analyses were performed to assess factors associated with poor adherence.

RESULTS

A total of 306 hypertensive outpatients participated in this study. 42.2% of participants were adherent to antihypertensive medications. Almost half of participants (49%) who reported having no comorbidities were adherent to antihypertensive medications compared to participants with one or more than one comorbidities 41, 39% respectively. The presence of comorbid conditions and being on multiple medications were significantly associated with medication adherence (-values, respectively, < 0.004, < 0.009). Patients with good knowledge about the disease and its complications were seven times more likely to have good adherence to medication ( <  0.001).

CONCLUSIONS

Non-adherence to medications is prevalent among a proportion of hypertensive patients which urges continuous monitoring to medication adherence with special attention to at risks groups of patients. Patients with comorbidities and on multiple medications were at high risk of medication non-adherence. Patients' knowledge on the disease was one of the main associated factors with non-adherence.

摘要

背景

高血压是心血管疾病的主要危险因素,而心血管疾病是全球死亡的主要原因。患者对治疗的依从性是控制高血压及其并发症的关键因素。本研究评估高血压患者对治疗的依从性及其相关因素。

方法

这项横断面研究在沙特阿拉伯利雅得进行。研究对象为年龄≥18岁且被诊断为高血压的门诊患者。采用系统抽样技术招募参与者。两项主要测量指标是使用Morisky量表评估抗高血压药物的依从率,以及确定高血压患者中药物依从性差的预测因素,包括社会经济和人口统计学数据、健康状况、门诊就诊、药物副作用、药物可及性和知识水平。进行描述性和逻辑回归分析以评估与依从性差相关的因素。

结果

共有306名高血压门诊患者参与了本研究。42.2%的参与者坚持服用抗高血压药物。报告无合并症的参与者中近一半(49%)坚持服用抗高血压药物,而有1种或多种合并症的参与者分别为41%和39%。合并症的存在和服用多种药物与药物依从性显著相关(P值分别<0.004,<0.009)。对疾病及其并发症有充分了解的患者坚持服药的可能性高出7倍(P<0.001)。

结论

一部分高血压患者中存在药物不依从的情况,这就需要持续监测药物依从性,尤其要关注高危患者群体。患有合并症且服用多种药物的患者药物不依从风险较高。患者对疾病的了解是与不依从相关的主要因素之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb8e/7491181/87834858d0f0/40885_2020_151_Fig1_HTML.jpg

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