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使用药物依从性原因量表(MAR量表)来确定中国高血压患者不依从治疗的原因。

Using the medication adherence reasons scale (MAR-scale) to identify the reasons for non-adherence in Chinese hypertensive patients.

作者信息

Pan Jingjing, Hu Bin, Xue Xiaorong, Wu Lian

机构信息

Department of Pharmacy, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, People's Republic of China.

Department of Ophthalmology, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, People's Republic of China.

出版信息

PLoS One. 2025 Jun 10;20(6):e0325004. doi: 10.1371/journal.pone.0325004. eCollection 2025.

Abstract

OBJECTIVES

This study aimed to determine the prevalence of medication non-adherence and to explore the factors influencing it among Chinese hypertensive patients.

PATIENTS AND METHODS

A total of 571 hypertensive patients hospitalized in a tertiary hospital in Xi'an, China were invited to participate in this cross-sectional study. The Chinese Version of Medication Adherence Reasons Scale (ChMAR-Scale) was used to identify the most common reasons for non-adherence to hypertension medications.Binary logistic regression analysis was employed to analyze independent risk factors for adherence in hypertensive patients.Descriptive statistics were used to calculate the adherence rates and trends in the reasons for non-adherence.

RESULTS

Approximately 66.9% of the patients did not adhere to their medications.Age (adjusted odds ratio [AOR] = 0.976, 95%CI:0.955-0.998, P = 0.032),education level(AOR = 0.566, 95% CI:0.419-0.765,P < 0.001) and blood pressure (BP) categories (AOR = 0.580, 95% CI: 0.439-0.767,P < 0.001) were independently associated with hypertensive medication adherence. Belief issues and self-perception issues were identified as the main reasons for medication non-adherence.These included self-adjustment of medications according to BP or physical condition, checking whether the medicine was still needed, concerns about long-term effects, and the belief that there was no longer a need to take the medicine.

CONCLUSION

Poor medication adherence is widespread among Chinese hypertension patients. More attention should be paid,and effective strategies should be developed to address the factors affecting treatment adherence.These factors include certain sociodemographic factors,such as age,education level and BP categories as well as belief issues and self-perception issues of hypertensive patients. The findings of this study can potentially assist healthcare providers in formulating targeted interventions to improve medication adherence.

摘要

目的

本研究旨在确定中国高血压患者药物治疗不依从的患病率,并探讨影响其的因素。

患者与方法

邀请了中国西安一家三级医院住院的571例高血压患者参与这项横断面研究。使用中文版药物依从性原因量表(ChMAR-Scale)来确定不依从高血压药物治疗的最常见原因。采用二元逻辑回归分析来分析高血压患者依从性的独立危险因素。描述性统计用于计算依从率和不依从原因的趋势。

结果

约66.9%的患者未坚持服药。年龄(调整优势比[AOR]=0.976,95%置信区间:0.955 - 0.998,P = 0.032)、教育水平(AOR = 0.566,95%置信区间:0.419 - 0.765,P < 0.001)和血压(BP)类别(AOR = 0.580,95%置信区间:0.439 - 0.767,P < 0.001)与高血压药物治疗依从性独立相关。信念问题和自我认知问题被确定为药物治疗不依从的主要原因。这些原因包括根据血压或身体状况自行调整药物、检查是否仍需用药、对长期影响的担忧以及认为不再需要服药。

结论

中国高血压患者中药物治疗依从性差的情况普遍存在。应给予更多关注,并制定有效策略来解决影响治疗依从性的因素。这些因素包括某些社会人口学因素,如年龄、教育水平和血压类别,以及高血压患者的信念问题和自我认知问题。本研究结果可能有助于医疗服务提供者制定有针对性的干预措施,以提高药物治疗依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac4f/12151354/1f77b6948bfc/pone.0325004.g001.jpg

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