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心房颤动患者的健康素养与口服抗凝治疗依从性的关系:一项横断面研究。

Relationship of health literacy and adherence to oral anticoagulation therapy in patients with atrial fibrillation: a cross-sectional study.

作者信息

Bartolazzi Frederico, Ribeiro Antônio Luiz Pinho, de Sousa Waleska Jaclyn Freitas Nunes, Vianna Mayara Sousa, da Silva José Luiz Padilha, Martins Maria Auxiliadora Parreiras

机构信息

Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, CEP 30130-100, Brazil.

Hospital das Clínicas da Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 110, Santa Efigênia, Belo Horizonte, Minas Gerais, CEP 30130-100, Brazil.

出版信息

J Thromb Thrombolysis. 2021 Nov;52(4):1074-1080. doi: 10.1007/s11239-021-02432-4. Epub 2021 Apr 15.

Abstract

Oral anticoagulant therapy (OAT) has increased substantially due to the aging population and prevalence rise of atrial fibrillation (AF). Medication adherence is important to achieve effectiveness and safety of OAT. The study aim was to investigate the relationship between health literary (HL) and the adherence to OAT in patients with atrial fibrillation (AF). This is a cross-sectional study conducted in a public cardiology clinic in Brazil, 2019. Sociodemographic and clinical data were collected by the review of medical records and interviews with patients. The relation between health literacy (HL) and adherence to OAT was investigated by a multiple logistic regression model. Overall, 100 AF patients were included in this study, with average age of 68.8 ± 13.8 years and predominance of women (54 %). Inadequate HL was found in 79 % of the patients and non-adherence was identified in 66 % of the participants. Sex was the only variable with a statistically significant association with non-adherence to OAT. Men presented a 2.54-fold greater chance of non-adherence to OAT, when compared to the women (Odds ratio (OR) = 2.54; 95 % confidence interval (CI): 1.03-6.62; p = 0.047). No statistically significant relationship was found between inadequate HL and non-adherence to OAT (OR 1.48; 95 % CI, 0.47-4.61; p = 0.49). High rates of inadequate HL and non-adherence to OAT were identified in this study; however, this relationship did not prove to be statistically significant. Further studies are needed to investigate factors associated with non-adherence to OAT in large samples of vulnerable populations and strategies for its improvement in public health.

摘要

由于人口老龄化和心房颤动(AF)患病率上升,口服抗凝治疗(OAT)显著增加。药物依从性对于实现OAT的有效性和安全性很重要。本研究旨在调查健康素养(HL)与心房颤动(AF)患者OAT依从性之间的关系。这是一项于2019年在巴西一家公立心脏病诊所进行的横断面研究。通过查阅病历和与患者访谈收集社会人口学和临床数据。通过多元逻辑回归模型研究健康素养(HL)与OAT依从性之间的关系。本研究共纳入100例AF患者,平均年龄为68.8±13.8岁,女性占多数(54%)。79%的患者健康素养不足,66%的参与者存在不依从情况。性别是与OAT不依从具有统计学显著关联的唯一变量。与女性相比,男性不依从OAT的可能性高2.54倍(比值比(OR)=2.54;95%置信区间(CI):1.03 - 6.62;p = 0.047)。未发现健康素养不足与OAT不依从之间存在统计学显著关系(OR 1.48;95% CI,0.47 - 4.61;p = 0.49)。本研究中健康素养不足和OAT不依从的发生率较高;然而,这种关系并未被证明具有统计学显著性。需要进一步研究以调查弱势群体大样本中与OAT不依从相关的因素及其在公共卫生方面的改善策略。

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