Wu You, Xiong Shangzhi, Zhu Gangjiao, Chen Xinyue, Zhang Mingyang, Gong Enying, Li Chong, Jia Peng, Østbye Truls, Yan Lijing L
Global Health Research Center, Duke Kunshan University, Kunshan, China.
The George Institute for Global Health, Faulty of Medicine and Health, University of New South Wales, Sydney, Australia.
Explor Res Clin Soc Pharm. 2024 Jul 20;15:100482. doi: 10.1016/j.rcsop.2024.100482. eCollection 2024 Sep.
While suboptimal medication adherence remains an obstacle to the management of hypertension and diabetes in China, few studies have investigated associated factors with medication adherence on different dimensions simultaneously.
To systematically examine associated patient, family, and community factors with suboptimal medication adherence among people with hypertension and/or type 2 diabetes in China.
The study stratified a random sample of 622 adults aged 45 years or older with hypertension and/or type 2 diabetes from three southeast cities in China in 2019. Trained interviewers used the Morisky Green Levine Medication Adherence Scale, Self-Efficacy to Manage Chronic Disease (SEMCD) Scale, and the Family Adaptability, Partnership, Growth, Affection, and Resolve (APGAR) Scale to assess medication adherence, self-efficacy, and family function, respectively. Participants also reported their perceived satisfaction with community health services (quantity, quality, affordability, and overall acceptance). The study used the multivariable logistic regression to assess the association of patient, family, and community factors with suboptimal medication adherence.
Among the participants, 42.9% reported suboptimal medication adherence. In the multivariable logistic regression model, male participants (odds ratio [OR] = 0.55, = 0.001) had higher medication adherence compared to females. Having a self-efficacy score that was lower than or equal to the sample mean was significantly associated with lower adherence (OR = 1.44, = 0.039). Participants unsatisfied with the affordability of community health services and medicine had lower adherence (OR = 2.18, 0.028) than those neutral or satisfied. There were no significant associations between family function and medication adherence.
Sex, self-efficacy, and perceived affordability of community health services were important factors associated with medication adherence. Healthcare professionals are recommended to consider multiple factors and leverage services and resources in community health centers when promoting medication adherence.
在中国，用药依从性欠佳仍是高血压和糖尿病管理的障碍，但很少有研究同时从不同维度调查与用药依从性相关的因素。
系统研究中国高血压和/或2型糖尿病患者用药依从性欠佳的相关患者、家庭和社区因素。
该研究对2019年来自中国东南部三个城市的622名年龄在45岁及以上的高血压和/或2型糖尿病成年人随机样本进行分层。经过培训的访谈员分别使用Morisky Green Levine用药依从性量表、慢性病自我管理效能感（SEMCD）量表和家庭亲密度和适应性量表（APGAR）来评估用药依从性、自我效能感和家庭功能。参与者还报告了他们对社区卫生服务的满意度（数量、质量、可承受性和总体接受度）。该研究使用多变量逻辑回归来评估患者、家庭和社区因素与用药依从性欠佳之间的关联。
在参与者中，42.9%报告用药依从性欠佳。在多变量逻辑回归模型中，男性参与者（比值比[OR]=0.55，P=0.001）的用药依从性高于女性。自我效能感得分低于或等于样本均值与较低的依从性显著相关（OR=1.44，P=0.039）。对社区卫生服务和药品可承受性不满意的参与者的依从性（OR=2.18，P=0.028）低于持中立或满意态度的参与者。家庭功能与用药依从性之间无显著关联。
性别、自我效能感和对社区卫生服务的可承受性感知是与用药依从性相关的重要因素。建议医疗保健专业人员在促进用药依从性时考虑多种因素，并利用社区卫生中心的服务和资源。
