基于提醒性药盒的社区综合干预对高血压患者遵医行为影响

Intervention Effectiveness of Medication Holder with Timer on Enhancing Compliance of Patients with Hypertension in Community

目的探讨基于提醒性药盒的社区综合干预对高血压患者遵医行为的影响。方法采用随机化对照试验,将100例高血压患者随机分为实验组和对照组,两组于2004年1—12月实施干预,均给予健康教育,并对实验组给予特制提醒性药盒。于2005年1—12月对两组患者进行随访观察。结果实验组共有48例、对照组共有45例完成试验。干预结束时和干预后随访结束时,两阶段实验组和对照组间知识知晓得分差别均无统计学意义(t=1.04和1.79,P>0.05),但实验组信念态度得分和行为生活方式得分高于对照组(t=3.03～19.89,P<0.01)。两阶段的遵医行为(包括合理膳食、不吸烟、适量运动、心理平衡、血压定时检测、规律服药)实验组均优于对照组(χ2=4.77～13.84,P<0.05),实验组血压控制情况均优于对照组(χ2=6.30和13.18,P<0.05)。干预结束后和干预后随访结束时相比,实验组行为改变得分变化无统计学意义(t=1.56,P>0.05),而对照组行为改变得分下降(t=5.75,P<0.01)。结论在健康教育的基础上,对社区高血压患者采用具有提醒功能的特制药盒,有利于"提醒"和"督促"患者建立并保持良好的遵医行为,从而有效控制高血压发展,值得推广应用。

Objective To explore an intervention method for improving compliance and seff-eare awareness/ability of patients with hypertension in community. Methods Patients with hypertension in community under health education were randomly divided into two groups; the experimental group was treated with medication holder with timer and the control group without it. In 2 groups, there were 50 cases and the experimental term was about 1 year. Result Investigations on post-intervention and one year after intervention demonstrated that the scores of correct knowledge awareness between experimental and control group had no difference （t= 1.04, 1.79,P〉0.05）. However, the scores of belief and attitude of experimental group were higher than those of control group （t=3.03 19.89, P〈0.01）, and the main compliance behavior indicators （including rational diet, non-smoking, moderate physical exercises, mentality balance, regular examination of the blood pressure and taking medication on time） were better in the experimental group than those in the control during two stages of intervention and one year after intervention （χ^2=4.77-13.84, P〈0.05）. The scores of behavior changes between post-intervention and one year after intervention in experimental group showed no difference （t=1.56, P〉0.05）, while the score in control group displayed decreasing trend （t=5.75, P〈0.01） during this period. The rates of regular blood pressure detecting and medication decreased by more than 20% in control group from post-intervention to one year after intervention. Conclusions Based on health education, providing medication holder with timer to patients with hypertension in community is effective method to remind and supervise patients keeping compliance as well as tying up relationship between physicians and patients. It deserves to popularize this effective way for controlling hypertension.