Takahashi Emiri, Vilay Phoutnalong, Chanthakoummane Ketmany, Pongvongsa Tiengkham, Kounnavong Sengchanh, Kano Shigeyuki, Kobayashi Jun, Nonaka Daisuke
Faculty of Pharmacy, Takasaki University of Health and Welfare, Takasaki, Gunma, Japan.
Center of Malariology, Parasitology and Entomology, Ministry of Health, Vientiane, Lao PDR.
Trop Med Health. 2021 Oct 29;49(1):88. doi: 10.1186/s41182-021-00374-4.
Although hypertension is becoming more prevalent among the adult population of the Lao People's Democratic Republic (PDR), with a prevalence of approximately 20% in 2013, treatment adherence of patients with hypertension, especially those in rural areas, remains poorly understood. The objective of the present study was to examine the rate of medication adherence to antihypertensive medicines among outpatients with hypertension in rural districts of the Savannakhet.
A prospective observational study was conducted in Xepon, Phin, and Nong districts. The study population was outpatients aged 18 years or older who were prescribed antihypertensive medicines at three district hospitals between February and August 2017. Data were collected on the first day of treatment (day 0) and the day of follow-up (around day 7) through interviews with the patients and outpatient registration books. The medication adherence rate was determined using the four-item Morisky Medication Adherence Scale. The level of adherence was evaluated by the sum of the scale, with scores ranging from 0 to 4 points. The adherent group, namely those with a score of 0, and the non-adherent group, namely those with scores of 1 to 4 points, were compared. Fisher's exact test was used to identify factors associated with medication adherence.
Of the 68 patients examined, 38.2% newly began treatment. Half of the patients (n = 34, 50.0%, 95% CI 0.38 to 0.62) adhered to medication instructions. The adherent group was more likely to have received written instructions when prescribed medication, compared to the non-adherent group (79.4% vs 55.9%, p = 0.068). Those who perceived that hypertension needs lifelong treatment were significantly more likely to adhere to the medication regimen (p = 0.028).
Medication adherence was present among 50% of outpatients with hypertension who visited a district hospital. Therefore, providing written instructions to patients would be effective for improving medication adherence.
尽管高血压在老挝人民民主共和国成年人口中越来越普遍，2013年的患病率约为20%，但高血压患者，尤其是农村地区患者的治疗依从性仍知之甚少。本研究的目的是调查沙湾拿吉农村地区高血压门诊患者对抗高血压药物的用药依从率。
在色蓬、芬和农县进行了一项前瞻性观察研究。研究人群为2017年2月至8月期间在三家县医院开具抗高血压药物处方的18岁及以上门诊患者。通过与患者访谈和门诊登记册，在治疗第一天（第0天）和随访日（约第7天）收集数据。使用四项Morisky用药依从性量表确定用药依从率。依从性水平通过量表总和进行评估，分数范围为0至4分。比较了依从组（即得分为0的患者）和非依从组（即得分为1至4分的患者）。使用Fisher精确检验确定与用药依从性相关的因素。
在68名接受检查的患者中，38.2%为新开始治疗。一半的患者（n = 34，50.0%，95%CI 0.38至0.62）遵守用药说明。与非依从组相比，依从组在开具药物处方时更有可能收到书面说明（79.4%对55.9%，p = 0.068）。那些认为高血压需要终身治疗的患者显著更有可能遵守用药方案（p = 0.028）。
在前往县医院就诊的高血压门诊患者中，50%存在用药依从性。因此，向患者提供书面说明对提高用药依从性有效。
