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秘鲁糖尿病和高血压患者药物治疗依从性差的相关因素:六年基于人群的调查综合分析结果。

Factors associated with poor adherence to medication in patients with diabetes and hypertension in Peru: findings from a pooled analysis of six years of population-based surveys.

机构信息

Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, Arequipa, Peru.

Universidad Nacional de San Antonio Abad del Cusco, Escuela Profesional de Medicina Humana, Asociación Científica de Estudiantes de Medicina Humana del Cusco (ASOCIEMH CUSCO), Cusco, Peru.

出版信息

Public Health. 2024 Jun;231:108-115. doi: 10.1016/j.puhe.2024.03.012. Epub 2024 Apr 22.

Abstract

OBJECTIVE

To evaluate the factors associated with poor medication adherence in patients with DM and HTN in Peru.

STUDY DESIGN

A cross-sectional study.

METHODS

We analyzed data from the Peruvian Demographic and Family Health Survey from 2014 to 2019. Adjusted prevalence ratios (aPR) and their respective 95% confidence intervals (CI) were estimated to determine the factors associated with poor medication adherence.

RESULTS

We included 15,184 participants with a known diagnosis of DM and HTN. The frequency of poor medication adherence was 37.1%, with 36.7% among individuals with HTN and 29.2% among individuals with DM. Those belonging to age groups above 30 years (aPR: 0.77; 95% CI: 0.74-0.80, for the group ≥ 60 years) had a lower frequency of poor medication adherence. Meanwhile, being male (aPR: 1.03; 95% CI: 1.01-1.05), lacking health insurance (aPR: 1.08; 95% CI: 1.05-1.10), belonging to lower wealth quintiles (aPR: 1.12; 95% CI: 1.08-1.17, for the first quintile), and living in the mountain region (aPR: 1.09; 95% CI: 1.06-1.12) were associated with a higher frequency of poor medication adherence. These findings were consistent when stratifying by the type of disease.

CONCLUSION

This study showed that poor medication adherence is common in patients with HTN and DM in Peru and is associated with sociodemographic factors, highlighting the importance of public health approaches to improve adherence.

摘要

目的

评估秘鲁糖尿病和高血压患者药物治疗依从性差的相关因素。

研究设计

横断面研究。

方法

我们分析了 2014 年至 2019 年期间秘鲁人口与家庭健康调查的数据。采用调整后的患病率比(aPR)及其相应的 95%置信区间(CI)来确定与药物治疗依从性差相关的因素。

结果

我们纳入了 15184 名已知患有糖尿病和高血压的参与者。药物治疗依从性差的频率为 37.1%,其中高血压患者为 36.7%,糖尿病患者为 29.2%。年龄在 30 岁以上的人群(aPR:0.77;95%CI:0.74-0.80,60 岁以上人群)药物治疗依从性差的频率较低。而男性(aPR:1.03;95%CI:1.01-1.05)、没有医疗保险(aPR:1.08;95%CI:1.05-1.10)、处于较低财富五分位数(aPR:1.12;95%CI:1.08-1.17,五分位数 1)和居住在山区(aPR:1.09;95%CI:1.06-1.12)与药物治疗依从性差的频率较高相关。这些发现与疾病类型分层时一致。

结论

本研究表明,秘鲁高血压和糖尿病患者药物治疗依从性差较为常见,与社会人口学因素相关,突出了采取公共卫生措施来提高依从性的重要性。

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