University Hassan First of Settat, Laboratoire Sciences et Technologies de la Santé, Institut Supérieur, des Sciences de la Santé, Settat, Morocco.
University Mohammed V, Faculté de Médecine et de Pharmacie de Rabat, Morocco.
Eur J Cardiovasc Nurs. 2021 May 22;20(4):324-330. doi: 10.1093/eurjcn/zvaa002.
Hypertension is a widespread public health problem; unfortunately, non-adherence to the treatment hinders the control of high blood pressure. Drug non-adherence is the degree to which a patient does not follow the prescription. We aimed to assess the extent of drug non-adherence among hypertensive patients treated in Meknes and identify risk factors associated with inobservance.
Between November and December 2017, we conducted a cross-sectional study enrolling 922 hypertensive patients managed at Meknes's primary healthcare facilities (PHCF) using the multistage sampling method. We interviewed patients face to face to collect their socio-demographic characteristics, lifestyle behaviours, clinical parameters, and the relationship between the care system, the patient, and the physician. A multivariate logistic regression analysis highlighted the risk factors associated with drug non-adherence. The prevalence of drug non-adherence was 91% with a mean age of 61 ± 11 years (mean ± standard deviation) and a male/female ratio of 1/3. Risk factors associated with drug non-adherence were: (i) male sex [adjusted odds ratio (AOR) = 2.5, 95% confidence interval (CI) (1.26-5.10)]; (ii) monthly income per household <150$ [AOR = 4.47, 95% CI (1.22-16.34)]; (iii) monthly income per household 150-200$ [AOR = 4.44, 95% CI (1.04-18.93)]; (iv) bad relationship with the healthcare system [AOR = 2.17, 95% CI (1.29-3.67)]; and (v) uncontrolled blood pressure [AOR = 1.87, 95% CI (1.15-3.02)].
The prevalence of drug non-adherence is general among hypertensive patients in Meknes. Prevention should: (i) ensure the availability of adequate stocks of the anti-hypertensive drug at the PHCF; (ii) secure sufficient drug stocks to treat the poorest patients first; and (iii) improve blood pressure control in patients.
高血压是一个普遍存在的公共卫生问题；不幸的是，治疗不依从会妨碍高血压的控制。药物不依从是指患者不遵守处方的程度。我们旨在评估梅克内斯治疗的高血压患者的药物不依从程度，并确定与不遵医嘱相关的风险因素。
在 2017 年 11 月至 12 月期间，我们采用多阶段抽样方法，在梅克内斯的初级医疗保健机构（PHCF）对 922 名高血压患者进行了横断面研究。我们面对面采访了患者，收集了他们的社会人口统计学特征、生活方式行为、临床参数以及医疗保健系统、患者和医生之间的关系。多变量逻辑回归分析突出了与药物不依从相关的风险因素。药物不依从的患病率为 91%，平均年龄为 61±11 岁（平均值±标准差），男女比例为 1/3。与药物不依从相关的风险因素包括：（i）男性[校正比值比（AOR）=2.5，95%置信区间（CI）（1.26-5.10）]；（ii）每户家庭每月收入<150 美元[AOR=4.47，95%CI（1.22-16.34）]；（iii）每户家庭每月收入 150-200 美元[AOR=4.44，95%CI（1.04-18.93）]；（iv）与医疗保健系统的关系不好[AOR=2.17，95%CI（1.29-3.67）]；和（v）血压未得到控制[AOR=1.87，95%CI（1.15-3.02）]。
梅克内斯高血压患者的药物不依从率普遍较高。预防措施应：（i）确保 PHCF 有足够的抗高血压药物库存；（ii）确保为最贫困的患者提供足够的药物库存；和（iii）改善患者的血压控制。
