天津市某社区老年高血压患者药物治疗依从性调查

Study on CPAT among Elderly Hypertensive Patients in a Community of Tianjin

目的了解社区老年高血压患者药物治疗依从性并探讨其影响因素。方法对362例天津市河西区尖山街社区服务中心老年高血压患者采用门诊及电话随访进行问卷调查,采用MOR1SKY评价高血压药物治疗依从性。结果服药依从性佳者占67.1%,不佳占32.9%。依从性不佳者中,32.77%患者认为服药后血压恢复正常就可以停药,23.53%认为无症状没必要服药,18.49%因用药复杂忘了服药。单因素分析结果显示,文化程度、服药种类、服药次数、并发症、会自测血压及规律自测血压对高血压药物治疗依从性有统计学意义(P<0.05)。非条件Logistic多因素回归分析显示,规律自测血压、服药种类及服药次数是影响高血压药物治疗依从性的独立因素(分别为OR=1.962,95%CI:1.137～3.383,OR=0.275,95%CI:0.144～0.525,OR=0.580,95%CI:0.414～0.812)。结论该社区老年高血压患者药物治疗依从性相对较高,但仍需普及并落实高血压防治指南,选择最佳治疗方案,大力推广家庭自测血压等。

Objective To analyze the situation of compliance of patient with anti-hypertension therapy （CPAT） and its influence factors. Methods 362 cases of elderly patients from a community service center in Hexi district of Tianjin were randomly selected and studied with questionnaire by outpatient service and telephone interview method, and their CPAT was evaluated with MOR1SKY. Results The compliance rate was 67.1% and non-compliance was 32.9%. In non-compliance patients, 32.77% of them thought that he could stop taking medicine when blood pressure was normal after medication, 23.53% of them had an idea that there was no need to take medicine due to asymptomatic, 18.49% of them forgot to take medication because of complexity of medication regimens. Univariate anatvsis showed that education level, types of medication, times of medication, complications, able to self-test blood pressure and regularly taking self-test on BP were statistically significant on the CPAT （all P〈0.05）. The Logistic regression analysis showed that regularity of self-testing blood pressure （OR=1.962, 95%C1：1.137-3.383）, types （0.275, 0.144-0.525） and frequency （0.580, 0.414-0.812） of medication were the independent and significant influencing factors for medication compliance. Conclusion We should implement the hypertension guidelines, promote health education, choose the best treatment options, and call to action on blood pressure monitoring at home, etc. All measurements could improve Compliance of Patient with Anti-hypertension Therapy .