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摩洛哥马拉喀什高血压患者中抗高血压药物治疗依从性及其危险因素

Non-adherence to antihypertensive drugs and its risk factors among hypertensive patients, Marrakech, Morocco.

作者信息

Belayachi Safae, Boukhari Fatima Zahra, Essayagh Firdaous, Terkiba Othmane, Zohoun Alban, Essayagh Meriem, Essayagh Touria, Essayagh Sanah

机构信息

Laboratoire Agroalimentaire et Santé, Faculté des Sciences et Techniques, Hassan First University of Settat, Settat, Morocco.

Laboratoire Droit Privé et Enjeux de Développement, Faculté des Sciences Juridiques, Économiques et Sociales, Université Sidi Mohamed Ben Abdellah, Fès, Morocco.

出版信息

PLOS Glob Public Health. 2024 Aug 27;4(8):e0002774. doi: 10.1371/journal.pgph.0002774. eCollection 2024.

Abstract

Non-adherence to hypertensive drugs is a barrier to controlling blood pressure and decreases hypertensive patients' quality of life. The aim of this study was to determine the prevalence of non-adherence to hypertensive drugs among hypertensive patients treated at Marrakech's primary health care facilities. A cross-sectional survey of 922 hypertensive patients treated at Marrakech's primary health care facilities for arterial hypertension was conducted between 2021 and 2022. For collecting data, two questionnaires were employed. One was administered during an interview to patients and focused on socio-demographic, behavioral, and clinical variables, as well as hypertensive treatment characteristics and the care-patient-physician triad. The physician self-administered the second questionnaire to assess therapeutic inertia. Non-adherence risk factors were identified using multivariate logistic regression. A total of 760 participants did not adhere to the hypertensive drugs, with a prevalence of 82.4%. The average age was 62.8±9.8 years, and 600 (78.9%) of the participants were female. Moderate stress, unsatisfactory family support, uncontrolled hypertension, the presence of depressive symptoms, an insufficient patient-physician interaction, and inadequate medical management of cardiovascular risk factors were associated with drug non-adherence. Non-adherence to hypertensive treatment is common in Marrakech. Regular therapeutic education classes and support group meetings must be scheduled. A performance-based remuneration system to incentivize health-care workers should be investigated.

摘要

不坚持服用降压药物是控制血压的一个障碍,会降低高血压患者的生活质量。本研究的目的是确定在马拉喀什初级卫生保健机构接受治疗的高血压患者中不坚持服用降压药物的患病率。2021年至2022年期间,对在马拉喀什初级卫生保健机构接受动脉高血压治疗的922名高血压患者进行了横断面调查。为收集数据,使用了两份问卷。一份在对患者的访谈中进行,重点关注社会人口学、行为和临床变量,以及高血压治疗特征和医患医联体。医生自行填写第二份问卷以评估治疗惰性。使用多因素逻辑回归确定不坚持服药的危险因素。共有760名参与者未坚持服用降压药物,患病率为82.4%。平均年龄为62.8±9.8岁,600名(78.9%)参与者为女性。中度压力、家庭支持不令人满意、高血压未得到控制、存在抑郁症状、医患互动不足以及心血管危险因素的医疗管理不足与药物不依从有关。在马拉喀什,不坚持高血压治疗的情况很常见。必须安排定期的治疗教育课程和支持小组会议。应该研究一种基于绩效的薪酬制度来激励医护人员。

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