Cao Wenjing, Kadir Azidah Abdul, Wang Juan, Hu Lin, Wen Linlan, Yu Mei, Peng Liqun, Chen Lanying, Luo Na, Hassan Intan Idiana
School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia.
Xiang Nan University, Chenzhou, Hunan, China.
Front Pharmacol. 2022 Nov 24;13:1054603. doi: 10.3389/fphar.2022.1054603. eCollection 2022.
Medication non-adherence has remained a common and costly global health issue of growing importance among older adults. This study aims to determine the prevalence and associated factors related to medication non-adherence among older adult stroke survivors in China. In this cross-sectional study, a total of 402 older adult stroke survivors were recruited from three tertiary hospitals in China. The results of the survey showed that 61.4% exhibited medication non-adherence. The chances of medication non-adherence among older adult stroke survivors who had primary school or less educational levels were higher than those who had senior secondary and junior college educational levels [OR (95% CI) = 0.440(0.249, 0.778)] as well as those who had a bachelor's degree or above educational levels [OR (95%CI) = 0.367(0.202, 0.667)]. Moreover, the probability of medication non-adherence with 4-5 and ≥6 types of total prescription medications per day increased by 1.993 times [OR (95% CI) = 1.993(1.190, 3.339))] and 2.233 times [OR (95%CI) = 2.233(1.159, 4.300)], respectively, as compared to when there were ≤3 types. Furthermore, medication non-adherence decreased with the increase in health literacy scores ( = -0.641 (95% CI; (0.913, 0.965)) and BMQ specific-necessity scores ( = -0.131 (95% CI; 0.806, 0.995)). On the other hand, when the BMQ specific-concerns score increased by one unit, medication non-adherence increased by 11.1% [OR (95% CI) = 1.111(1.044, 1.182)]. The present study found that patient medication adherence among older adult stroke survivors in China is problematic and associated with educational levels, total prescribed drugs per day, beliefs about medication, and health literacy scores. This indicates that measures should be taken to enhance medication adherence among such higher-risk populations.
药物治疗依从性仍然是一个常见且代价高昂的全球健康问题，在老年人中日益重要。本研究旨在确定中国老年中风幸存者中药物治疗不依从的患病率及其相关因素。在这项横断面研究中，从中国的三家三级医院招募了总共402名老年中风幸存者。调查结果显示，61.4%的人存在药物治疗不依从情况。小学及以下文化程度的老年中风幸存者药物治疗不依从的可能性高于高中和大专文化程度的幸存者[比值比（95%置信区间）=0.440（0.249，0.778）]以及本科及以上文化程度的幸存者[比值比（95%置信区间）=0.367（0.202，0.667）]。此外，与每天总处方药种类≤3种相比，每天4 - 5种和≥6种总处方药的药物治疗不依从概率分别增加了1.993倍[比值比（95%置信区间）=1.993（1.190，3.339）]和2.233倍[比值比（95%置信区间）=2.233（1.159，4.300）]。此外，药物治疗不依从随着健康素养得分的增加而降低（=-0.641（95%置信区间；（0.913，0.965））以及BMQ特定必要性得分的增加而降低（=-0.131（95%置信区间；0.806，0.995））。另一方面，当BMQ特定担忧得分增加一个单位时，药物治疗不依从增加11.1%[比值比（95%置信区间）=1.111（1.044，1.182）]。本研究发现，中国老年中风幸存者的患者药物治疗依从性存在问题，且与文化程度、每天的总处方药量、对药物的信念以及健康素养得分有关。这表明应采取措施提高这类高危人群的药物治疗依从性。
