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基层医疗中高血压患者的治疗依从性

Therapeutic Compliance of Patients with Arterial Hypertension in Primary Care.

作者信息

Iancu Mihaela Adela, Mateiciuc Irina-Ioana, Stanescu Ana-Maria Alexandra, Matei Dumitru, Diaconu Camelia Cristina

机构信息

Department 5, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Primary Care Office, 011165 Bucharest, Romania.

出版信息

Medicina (Kaunas). 2020 Nov 22;56(11):631. doi: 10.3390/medicina56110631.

Abstract

Arterial hypertension remains an important cause of cardiovascular morbidity and mortality, despite all the progress made in the methods of diagnosis, monitoring of target organs' damage and treatment. The main cause of the increased prevalence of uncontrolled blood pressure values is the low compliance to antihypertensive treatment. The objective of our study was to assess the compliance to the treatment of patients diagnosed with arterial hypertension and monitored in a primary care office. The cross-sectional, retrospective study included 129 patients, 65.89% (85) women, previously diagnosed with arterial hypertension. Data from the medical files were analyzed, as well as the patients' answers to a survey of 18 questions regarding arterial hypertension, comorbidities, complications, treatment and awareness of the condition. The study included 129 patients, with a mean age of 66 ± 8 years. The majority of patients were overweight, 55.81% (72 patients), and 10.85% (14 patients) had grade I obesity. Most of the patients, 55.81% (72 patients) were diagnosed with grade III hypertension, while 37.98% (49 patients) were diagnosed with grade II hypertension and 6.2% (8 patients) with grade I hypertension. One third of the surveyed patients answered that they follow the recommendations of a low-sodium diet, 21.7% are adherent to treatment, but 56% think that the total cost of the medication is an impediment for their compliance to treatment. The majority, 82.17% (106 patients), of respondents had an affirmative answer to the questions: 'Do you think it would be easier to take one pill instead of 2, 3 or 4 pills?' The increased compliance to the antihypertensive treatment and control of blood pressure values are associated with the degree of awareness of arterial hypertension and the consequences if left untreated, emphasizing the role of the general practitioner in counseling for secondary prevention.

摘要

尽管在诊断方法、靶器官损害监测和治疗方面取得了诸多进展,但动脉高血压仍是心血管疾病发病和死亡的重要原因。血压控制不佳患病率上升的主要原因是对抗高血压治疗的依从性低。我们研究的目的是评估在初级保健诊所诊断并接受监测的动脉高血压患者的治疗依从性。这项横断面回顾性研究纳入了129例先前被诊断为动脉高血压的患者,其中65.89%(85例)为女性。分析了病历数据以及患者对一份关于动脉高血压、合并症、并发症、治疗和病情知晓情况的18个问题的调查问卷的回答。该研究包括129例患者,平均年龄为66±8岁。大多数患者超重,占55.81%(72例),10.85%(14例)为I级肥胖。大多数患者,55.81%(72例)被诊断为III级高血压,而37.98%(49例)被诊断为II级高血压,6.2%(8例)为I级高血压。三分之一的受访患者回答他们遵循低钠饮食建议,21.7%坚持治疗,但56%认为药物的总费用是他们依从治疗的障碍。大多数受访者,82.17%(106例)对“你认为服用1片药比服用2片、3片或4片药更容易吗?”这个问题给出了肯定回答。抗高血压治疗依从性的提高和血压值的控制与对动脉高血压的知晓程度以及不治疗的后果相关,强调了全科医生在二级预防咨询中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e00/7700472/c5c0394fa18d/medicina-56-00631-g001.jpg

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