Malkon Salpe, Wettermark Björn, Kahan Thomas, Bastholm-Rahmner Pia, Hasselström Jan, Qvarnström Miriam
Department of Pharmacy, Uppsala University, Uppsala, Sweden.
Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Stockholm, Sweden.
Patient Prefer Adherence. 2023 Dec 13;17:3331-3339. doi: 10.2147/PPA.S429638. eCollection 2023.
Few studies explored what patients initiated on blood pressure medication in primary care think about their disease and their medications. The aim of this study was to gain an understanding of hypertensive patients' views on and experiences of hypertension and the use of antihypertensive medications.
A qualitative study based on open-ended questions from a survey on medication adherence, which captured treated hypertensive patients' perspective on their condition and treatment. Data were collected for 219 patients on antihypertensive medication, ≥ 30 years old, who consulted 25 primary health care centers in Stockholm, Sweden, during 2016. Thematic analysis with both inductive and deductive approach was applied.
We identified 21 codes from the data and grouped them under the World Health Organization's five dimensions of adherence: condition-, therapy-, health care team and system-, patient-, and socioeconomic-related factors. The analyses revealed that many patients with hypertension have limited knowledge of their disease, are afraid of drug side effects and experience various issues in primary health care that may negatively impact adherence, including short doctor appointments, prescribing without communication and room for improvement in individualization of therapy and a person-centered approach.
Many patients with hypertension have limited understanding of their hypertension and fear of adverse events from their antihypertensive medications. There is also room for improvement in how the patients are managed in primary health care. Interventions should focus on these issues to promote a better blood pressure target achievement.
很少有研究探讨在初级保健中开始服用降压药的患者对其疾病和药物的看法。本研究的目的是了解高血压患者对高血压以及使用抗高血压药物的看法和体验。
一项基于药物依从性调查中开放式问题的定性研究,该调查捕捉了接受治疗的高血压患者对其病情和治疗的看法。收集了2016年期间在瑞典斯德哥尔摩25个初级保健中心就诊的219名年龄≥30岁的服用抗高血压药物患者的数据。采用归纳和演绎相结合的主题分析法。
我们从数据中识别出21个编码,并将它们归类到世界卫生组织依从性的五个维度下:病情相关因素、治疗相关因素、医疗团队和系统相关因素、患者相关因素以及社会经济相关因素。分析表明,许多高血压患者对其疾病的了解有限,害怕药物副作用,并且在初级保健中经历各种可能对依从性产生负面影响的问题,包括医生问诊时间短、不开具说明就开药,以及在治疗个体化和以患者为中心的方法方面有待改进。
许多高血压患者对其高血压的了解有限,并且害怕抗高血压药物的不良事件。在初级保健中对患者的管理方式也有改进的空间。干预措施应侧重于这些问题,以促进更好地实现血压目标。