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中国高血压患者治疗依从性的城乡差异

Urban-Rural Difference in Treatment Adherence of Chinese Hypertensive Patients.

作者信息

Pan Jingjing, Yu Haizhen, Hu Bin, Li Qiongge

机构信息

Department of Pharmacy, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, People's Republic of China.

Department of Clinical Laboratory, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, People's Republic of China.

出版信息

Patient Prefer Adherence. 2022 Aug 15;16:2125-2133. doi: 10.2147/PPA.S377203. eCollection 2022.

Abstract

OBJECTIVE

The aims of this study were to evaluate the treatment adherence and the main factors associated with adherence for Chinese hypertensive patients between urban and rural areas.

PARTICIPANTS AND METHODS

A total of 529 hypertensive patients with 328 from urban areas and 201 from rural areas hospitalized in a tertiary hospital in Xi'an, China during the period from May 1 to December 31, 2021 were invited to participate in the cross-sectional study. The adherence to treatment was assessed by "modified Chinese Hill-Bone compliance to high blood pressure therapy scale". Binary logistic regression analysis was used to analyze independent risk factor for treatment adherence of hypertensive patients. General linear model was used to analyze the association of the independent risk factors to treatment adherence in each subgroup of the scale.

RESULTS

The treatment adherence of Chinese hypertensive patients in rural areas was 23.88% and it was significantly lower than that in urban areas (36.59%). Age and gender were the factors that independently associated with treatment adherence of hypertensive patients regardless of urban or rural status. The duration of antihypertensive drugs used was identified to be the factor that independently associated with treatment adherence only in urban patients. The subgroups including reduced sodium intake and medication taking had significant effects on treatment adherence in certain factors.

CONCLUSION

The treatment adherence of Chinese hypertensive patients was low, especially in rural areas. More emphasis should be placed on patients in rural areas. Furthermore, more attention and effective strategies should be designed to address factors affecting treatment adherence in both urban and rural areas. Health programs should focus on education including the importance of taking continuous antihypertensive drugs and low sodium diet.

摘要

目的

本研究旨在评估中国城乡高血压患者的治疗依从性及其相关的主要因素。

参与者与方法

2021年5月1日至12月31日期间,在中国西安一家三级医院住院的529例高血压患者被邀请参加这项横断面研究,其中328例来自城市地区,201例来自农村地区。采用“改良中国Hill-Bone高血压治疗依从性量表”评估治疗依从性。采用二元逻辑回归分析高血压患者治疗依从性的独立危险因素。采用一般线性模型分析量表各亚组中独立危险因素与治疗依从性的关联。

结果

中国农村高血压患者的治疗依从性为23.88%,显著低于城市地区(36.59%)。无论城市还是农村,年龄和性别都是与高血压患者治疗依从性独立相关的因素。仅在城市患者中,使用降压药物的时长被确定为与治疗依从性独立相关的因素。包括减少钠摄入和服药在内的亚组在某些因素上对治疗依从性有显著影响。

结论

中国高血压患者的治疗依从性较低,尤其是农村地区。应更加关注农村地区的患者。此外,应设计更多关注并制定有效策略来解决影响城乡治疗依从性的因素。健康项目应注重教育,包括持续服用降压药物和低钠饮食的重要性。

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本文引用的文献

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Urban-rural disparities in hypertension management among middle-aged and older patients: Results of a 2018 Chinese national study.
Chronic Illn. 2023 Sep;19(3):581-590. doi: 10.1177/17423953221102627. Epub 2022 May 22.
2
The Effect of Social Support on Treatment Adherence in Hypertension in China.
Patient Prefer Adherence. 2021 Sep 7;15:1953-1961. doi: 10.2147/PPA.S325793. eCollection 2021.
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Curr Opin Cardiol. 2021 Jul 1;36(4):398-404. doi: 10.1097/HCO.0000000000000870.
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Patient adherence to antihypertensive medications in upper Egypt: a cross-sectional study.
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