Ruksakulpiwat Suebsarn, Schiltz Nicholas K, Irani Elliane, Josephson Richard A, Adams Jon, Still Carolyn Harmon
Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand.
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA.
Patient Prefer Adherence. 2024 May 7;18:957-975. doi: 10.2147/PPA.S459678. eCollection 2024.
Hypertension (HTN) significantly increases the risk of stroke and heart disease, which are the leading causes of death and disability globally, particularly among older adults. Antihypertensive medication is a proven treatment for blood pressure control and preventing complications. However, medication adherence rates in older adults with HTN are low. In this review, we systematically identified factors influencing medication adherence in older adults with HTN.
We applied the PRISMA guidelines and conducted systematic searches on PubMed, MEDLINE, and Google Scholar in July 2022 to identify preliminary studies reporting factors influencing medication adherence among older adults with HTN. The convergent integrated analysis framework suggested by the Joanna Briggs Institute for systematic reviews was adopted for data synthesis.
Initially, 448 articles were identified, and after title and abstract screening, 16 articles qualified for full-text review. During this phase, three articles were excluded for reporting on irrelevant populations or focusing on issues beyond the review's aim, leaving thirteen studies in the final review. After data synthesis, fifteen themes were extracted from the key findings of the included studies. The most prevalent themes included the number of medications used (53.9%, n=7 studies), financial status (38.5%, n=5), sex (38.5%, n=5), age (30.1%, n=4), duration of disease (23.1%, n=3), comorbidities (23.1%, n=3), and health compliance (23.1%, n=3). Other themes, such as education, health literacy, health belief, medication belief, perception of illness, patient-physician relationship, self-efficacy, and social support, were also identified.
The findings of this review highlight critical areas for developing innovative, evidence-based programs to improve medication adherence in hypertensive older adults. Insights from this review can contribute to improving medication adherence and preventing future health complications.
高血压（HTN）显著增加中风和心脏病风险，而中风和心脏病是全球尤其是老年人死亡和残疾的主要原因。抗高血压药物是控制血压和预防并发症的经证实有效的治疗方法。然而，老年高血压患者的药物依从率较低。在本综述中，我们系统地确定了影响老年高血压患者药物依从性的因素。
我们应用PRISMA指南，于2022年7月在PubMed、MEDLINE和谷歌学术上进行系统检索，以识别报告影响老年高血压患者药物依从性因素的初步研究。采用乔安娜·布里格斯循证卫生保健中心系统评价建议的聚合综合分析框架进行数据合成。
最初识别出448篇文章，经过标题和摘要筛选，16篇文章符合全文审查标准。在此阶段，排除了3篇报告无关人群或关注超出综述目的问题的文章，最终审查中留下13项研究。数据合成后，从纳入研究的主要发现中提取了15个主题。最普遍的主题包括用药数量（53.9%，n = 7项研究）、财务状况（38.5%，n = 5）、性别（38.5%，n = 5）、年龄（30.1%，n = 4）、病程（23.1%，n = 3）、合并症（23.1%，n = 3）和健康依从性（23.1%，n = 3）。还识别出了其他主题，如教育、健康素养、健康信念、药物信念、疾病认知、医患关系、自我效能和社会支持。
本综述的结果突出了开发创新的、基于证据的项目以改善老年高血压患者药物依从性的关键领域。本综述的见解有助于提高药物依从性并预防未来的健康并发症。
