在实施预防新冠疫情措施背景下越南慢性心血管疾病患者的药物依从性及对药物的认知
Medication Adherence and Belief about Medication among Vietnamese Patients with Chronic Cardiovascular Diseases within the Context of Implementing Measures to Prevent COVID-19.
作者信息
Nguyen Nguyet Kim, Diep Han Gia, Ly Hung Huynh Vinh, Nguyen Ngoc Le Minh, Taxis Katja, Pham Suol Thanh, Vo Trang Huynh, Nguyen Thang
机构信息
Department of Pharmacology and Clinical Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam.
Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam.
出版信息
J Cardiovasc Dev Dis. 2022 Jun 26;9(7):202. doi: 10.3390/jcdd9070202.
BACKGROUND
Long-term adherence is crucial for optimal treatment outcomes in chronic cardiovascular diseases (CVDs), especially throughout the COVID-19 wide-spreading periods, making patients with chronic CVDs vulnerable subjects.
AIM
To investigate the relationship between the characteristics, beliefs about prescribed medication, COVID-19 prevention measures, and medication adherence among patients with chronic CVDs.
METHODS
This is a cross-sectional study of outpatients with chronic CVDs in Southern Vietnam. The specific parts regarding the Beliefs about Medicines Questionnaires (BMQ-Specific) and the General Medication Adherence Scale (GMAS) were applied to assess the beliefs about and adherence to medication. The implementation measures to prevent COVID-19 in patients were evaluated according to the 5K message (facemask, disinfection, distance, no gathering, and health declaration) of the Vietnam Ministry of Health. A multivariable logistic regression with the Backward elimination (Wald) method was used to identify the associated factors of medication adherence.
RESULTS
A slightly higher score in BMQ-Necessity compared to BMQ-Concerns was observed. A total of 40.7% of patients were recorded as having not adhered to their medications. Patients' behavior was most frequently self-reported by explaining their non-adherence (34.7%). Statistical associations were found between rural living place, unemployment status, no or only one measure(s) of COVID-19 prevention application, and medication adherence.
CONCLUSION
During the COVID-19 spreading stage, patients generally showed a positive belief about medication when they rated the importance of taking it higher than its side effects. The data analysis suggested that rather than patients' beliefs, the clinicians should consider the patient factors, including living place, employment, and the number of epidemic preventive measures applied for guiding the target patients for improving medication adherence.
背景
长期坚持治疗对于慢性心血管疾病（CVD）的最佳治疗效果至关重要，尤其是在新冠疫情广泛传播期间，这使得慢性CVD患者成为易受影响的群体。
目的
探讨慢性CVD患者的特征、对处方药的信念、新冠预防措施与用药依从性之间的关系。
方法
这是一项对越南南部慢性CVD门诊患者的横断面研究。应用关于药物信念问卷（BMQ-特定）和一般药物依从性量表（GMAS）的特定部分来评估对药物的信念和依从性。根据越南卫生部的5K信息（口罩、消毒、距离、不聚集和健康申报）评估患者预防新冠的实施措施。采用向后逐步消除法（Wald）的多变量逻辑回归来确定用药依从性的相关因素。
结果
观察到BMQ-必要性得分略高于BMQ-担忧得分。共有40.7%的患者被记录为未坚持用药。患者最常通过解释不依从的原因来自我报告其行为（34.7%）。发现农村居住地点、失业状况、未采取或仅采取一项新冠预防措施与用药依从性之间存在统计学关联。
结论
在新冠疫情传播阶段，当患者认为服药的重要性高于其副作用时，他们对药物总体表现出积极的信念。数据分析表明，临床医生应考虑患者因素，包括居住地点、就业情况以及所采取的防疫措施数量，而非患者的信念，以指导目标患者提高用药依从性。
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