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高血压患者药物治疗依从性的患病率及影响因素:一项基于机构的横断面研究。

Prevalence and determinants of medication adherence among hypertensive patients: An institution-based cross-sectional study.

作者信息

Sharif Azaz Bin, Chowdhury Syed Sharaf Ahmed, Hossain Md Zakir, Hossain Md Anwar, Hossain Ahmed, Reza Hasan Mahmud

机构信息

Global Health Institute, North South University, Dhaka, Bangladesh.

Department of Public Health, North South University, Dhaka, Bangladesh.

出版信息

PLoS One. 2025 May 20;20(5):e0321449. doi: 10.1371/journal.pone.0321449. eCollection 2025.

Abstract

BACKGROUND

Adherence to antihypertensive medication is a key management strategy for hypertension, which gives rise to the necessity to get a clear picture of medication adherence among patients with hypertension in Bangladesh. This study aims to determine the prevalence of antihypertensive medication adherence and its associated factors among patients with hypertension receiving treatments at a Hypertension Center in Bangladesh.

METHODS

An institution-based cross-sectional study was conducted on 352 adult patients with hypertension registered in the Rangpur Hypertension and Research Center. The outcome variable for the study was medication adherence to the antihypertensive drug, which was measured using the Morisky Medication Adherence Scale (MMAS-8). Descriptive analysis was conducted to show the distribution of the study participants, Pearson's chi-square test was applied to explore associations between categorical response and explanatory variables, and bivariable and multivariable logistic regression analyses were conducted to explore factors associated with medication adherence. All statistical analyses were conducted using Stata version 17.0.

RESULTS

The prevalence of good medication adherence among patients with hypertension in the HRC, R was 54.83%. Among various reasons for taking the medicine irregularly, forgetfulness (20.29%) was the most common cause reported by the participants, followed by a busy work schedule (7.71%). Among the study participants, married patients were found to have higher medicine adherence (AOR= 3.81; 95% CI: 1.34-10.89) than unmarried patients. Compared to patients who had hypertension for less than or equal to 5 years, patients suffering from hypertension for 6-10 years had 68% (AOR= 0.32; 95% CI: 0.11-0.95) and patients suffering for more than 10 years had 72% (AOR= 0.28; 95% CI: 0.09-0.84) lower odds of medicine adherence, respectively. Patients who were diagnosed by non-professionals had 81% (AOR= 0.19; 95% CI: 0.06-0.61) lower odds of medicine adherence compared to the patients who were diagnosed by health professionals.

CONCLUSION

This study observed low medication adherence among patients with hypertension, where forgetfulness and a busy work schedule were reported to be the primary reasons for such non-adherence. Patients who are not married, who have been suffering for a long, and who have not been diagnosed by a health professional manifested as significant influencing factors for non-adherence.

摘要

背景

坚持服用抗高血压药物是高血压管理的关键策略,这使得有必要清楚了解孟加拉国高血压患者的药物依从性情况。本研究旨在确定在孟加拉国一家高血压中心接受治疗的高血压患者中抗高血压药物依从性的患病率及其相关因素。

方法

对在朗布尔高血压与研究中心登记的352名成年高血压患者进行了一项基于机构的横断面研究。该研究的结果变量是抗高血压药物的服药依从性,采用Morisky药物依从性量表(MMAS - 8)进行测量。进行描述性分析以展示研究参与者的分布情况,应用Pearson卡方检验来探索分类反应变量与解释变量之间的关联,并进行双变量和多变量逻辑回归分析以探索与药物依从性相关的因素。所有统计分析均使用Stata 17.0版本进行。

结果

朗布尔高血压与研究中心(R)的高血压患者中良好药物依从性的患病率为54.83%。在不定期服药的各种原因中,健忘(20.29%)是参与者报告的最常见原因,其次是工作繁忙(7.71%)。在研究参与者中,已婚患者的药物依从性(调整优势比[AOR]= 3.81;95%置信区间[CI]:1.34 - 10.89)高于未婚患者。与患高血压小于或等于5年的患者相比,患高血压6 - 10年的患者药物依从性的几率降低了68%(AOR = 0.32;95% CI:0.11 - 0.95),患高血压超过10年的患者药物依从性的几率降低了72%(AOR = 0.28;95% CI:0.09 - 0.84)。与由卫生专业人员诊断的患者相比,由非专业人员诊断的患者药物依从性的几率降低了81%(AOR = 0.19;95% CI:0.06 - 0.61)。

结论

本研究观察到高血压患者的药物依从性较低,其中健忘和工作繁忙被报告为这种不依从的主要原因。未婚、患病时间长且未由卫生专业人员诊断的患者表现为不依从的重要影响因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b809/12091766/8b50fce8c0d4/pone.0321449.g001.jpg

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