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在一家专业门诊诊所接受治疗的高血压患者的血压控制与药物治疗依从性:一项横断面研究。

Blood Pressure Control and Adherence to Drug Treatment in Patients with Hypertension Treated at a Specialized Outpatient Clinic: A Cross-Sectional Study.

作者信息

Guimarães Mayra Cristina da Luz Pádua, Coelho Juliana Chaves, da Silva Giovanio Vieira, Drager Luciano Ferreira, Gengo E Silva Butcher Rita de Cassia, Butcher Howard K, Pierin Angela Maria Geraldo

机构信息

Graduate Program in Adult Health Nursing (PROESA), University of São Paulo Nursing School, São Paulo, SP, Brazil.

Hypertension Unit, Renal Division, University of São Paulo Medical School, São Paulo, SP, Brazil.

出版信息

Patient Prefer Adherence. 2021 Dec 10;15:2749-2761. doi: 10.2147/PPA.S336524. eCollection 2021.

Abstract

OBJECTIVE

To evaluate and identify variables associated with the control of hypertension and adherence to antihypertensive drug treatment in a group of patients with hypertension monitored in a specialized, highly complex outpatient service.

METHODS

A prospective, cross-sectional study was carried out in the hypertension unit of a tertiary teaching hospital. Patients diagnosed with hypertensive aged 18 years and over and accompanied for at least six months were included in the study. Patients with secondary hypertension and pregnant women were excluded. The sample consisted of 253 patients. Adherence/concordance to antihypertensive treatment was assessed using the Morisky Green Levine Scale. Blood pressure control was set for values less than 140/90 mmHg. Variables with p≤0.20 in univariate analysis were included in multiple logistic regression. The level of significance adopted was p ≤0.05.

RESULTS

Most of patients were white, married and women, with a mean age of 65 (13.3) years old, low income, and education levels. Blood pressure control and adherence were observed in 69.2% and 90.1% of the patients, respectively. Variables that were independently associated with blood pressure control were (OR, odds ratio; CI, 95% confidence interval): married marital status (OR 2.3; CI 1.34-4.28), use of calcium channel blockers (OR 0.4; CI 0.19-0.92) and number of prescribed antihypertensive drugs (OR 0.78; CI 0.66-0.92). Adherence was not associated with any of the variables studied.

CONCLUSION

There was a high frequency of patients with satisfactory adherence to antihypertensive drug treatment. Blood pressure control was less frequent and was associated with social and treatment-related factors.

摘要

目的

评估并识别在一家专业、高度复杂的门诊服务机构接受监测的一组高血压患者中,与高血压控制及抗高血压药物治疗依从性相关的变量。

方法

在一家三级教学医院的高血压科开展了一项前瞻性横断面研究。纳入年龄在18岁及以上、已确诊高血压且至少有六个月随访记录的患者。排除继发性高血压患者和孕妇。样本包括253名患者。使用Morisky Green Levine量表评估抗高血压治疗的依从性/一致性。将血压控制目标设定为低于140/90 mmHg。单因素分析中p≤0.20的变量纳入多因素逻辑回归分析。采用的显著性水平为p≤0.05。

结果

大多数患者为白人、已婚女性,平均年龄65(13.3)岁,收入低,教育程度低。分别有69.2%和90.1%的患者实现了血压控制和依从治疗。与血压控制独立相关的变量为(OR,比值比;CI,95%置信区间):已婚婚姻状况(OR 2.3;CI 1.34 - 4.28)、使用钙通道阻滞剂(OR 0.4;CI 0.19 - 0.92)以及抗高血压药物的处方数量(OR 0.78;CI 0.66 - 0.92)。依从性与所研究的任何变量均无关联。

结论

抗高血压药物治疗依从性良好的患者比例较高。血压控制的比例较低,且与社会因素和治疗相关因素有关。

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