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巴西抗高血压药物治疗的依从性:系统评价和荟萃分析。

Adherence to antihypertensive drug treatment in Brazil: a systematic review and meta-analysis.

机构信息

BP - A Beneficência Portuguesa de São Paulo. R. Maestro Cardim 637, Bela Vista. 01323-001 São Paulo SP Brasil.

Escola de Enfermagem, Universidade de São Paulo. São Paulo SP Brasil.

出版信息

Cien Saude Colet. 2024 Aug;29(8):e19282022. doi: 10.1590/1413-81232024298.19282022. Epub 2023 Aug 23.

DOI:10.1590/1413-81232024298.19282022
PMID:39140552
Abstract

This article aims to evaluate the adherence to antihypertensive treatment prevalence in the Brazilian population based on peer-reviewed studies which used instruments exclusively designed and/or adapted for this purpose. A systematic review with meta-analysis based on the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search was carried out in the BDENF, SciELO, Cuiden, PsycINFOe, CINAHL, Embase, LILACS, and MEDLINE databases, as well as the AgeLine, Google Scholar and ScienceDirect academic search engines. The protocol was registered with PROSPERO (CRD42021292689). Random effects models were used for a meta-analysis of the prevalence obtained from individual studies. A total of 104 studies were included in the meta-analysis on antihypertensive treatment in the Brazilian population, totaling 38,299 patients. The most used instrument was the four-item Morisky-Green Test (49.5%). The adherence prevalence estimated by the meta-analysis was 44.4% (95%CI: 39.12%-49.94%, I2 = 91.17, p < 0.001), showing high heterogeneity. The adherence to antihypertensive treatment prevalence found in national studies was unsatisfactory, demonstrating that this problem continues to be a major challenge.

摘要

这篇文章旨在评估基于同行评审研究的巴西人群中抗高血压治疗的依从性,这些研究使用了专门为此目的设计和/或改编的仪器。这是一项基于系统评价和荟萃分析建议的系统评价,采用了 Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)的建议。检索范围包括 BDENF、SciELO、Cuiden、PsycINFOe、CINAHL、Embase、LILACS 和 MEDLINE 数据库,以及 AgeLine、Google Scholar 和 ScienceDirect 学术搜索引擎。该方案已在 PROSPERO(CRD42021292689)中注册。使用随机效应模型对个体研究中获得的流行率进行荟萃分析。共有 104 项关于巴西人群抗高血压治疗的研究纳入荟萃分析,共涉及 38299 名患者。最常用的仪器是四项 Morisky-Green 测试(49.5%)。荟萃分析估计的依从性流行率为 44.4%(95%CI:39.12%-49.94%,I2 = 91.17,p < 0.001),显示出高度异质性。全国性研究中发现的抗高血压治疗依从性并不令人满意,这表明这个问题仍然是一个主要挑战。

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