中国14所省会城市社区门诊高血压患者用药习惯调查

Medication-taking behavior in outpatients with primary hypertension in China:an epidemiological study of 14 capital cities

目的了解中国城市社区门诊高血压患者的用药习惯,为进一步控制高血压奠定基础。方法对中国14所省会城市部分社区门诊高血压患者进行体检和问卷调查。调查内容包括一般情况、病史、用药史及用药习惯,体检内容包括血压、心率、身高、体重、血生化、心电图等。结果入选研究共11861例,其中8295例(69.9%)正在服用降压药。医疗付费方式为全自费、部分自费、全公费、不清楚所占比例分别为30.3%、63.2%、4.8%和1.7%;服药方式为完全遵医嘱、病情严重时遵医嘱、完全自主服药所占比例分别为81.2%、16.2%和2.6%;疗效、价格、副作用以及服用方便是影响选择降压药的主要因素,所占的比例分别为86.7%、66.8%、54.6%和33.6%;医护人员、朋友家人和科普宣传是影响选药的主要人为因素,分别占85.3%、49.7%和28.8%;能获得更多医疗指导、价廉、方便是影响购药地点的主要因素,分别占33.5%、21.8%和19.5%;研究对象可接受的降压药物的最高花费平均为每月58元,家庭人均年收入越高可接收的最高药费也越高(F=49.9,P<0.001)。结论降压药品价格是影响我国社区门诊高血压患者择药的重要因素,使用经济合理的药物是提高高血压治疗率、控制率的关键;有必要加强对高血压防治知识的宣传教育,纠正部分患者择药服药的随意性,从而改善我国高血压的控制情况。

Objective To investigate the medication-taking behavior of outpatients with primary hypertension in China,so as to lay a foundation for further control of hypertension.Methods Questionnaire investigations as well as physical examination were conducted among 11 861 outpatients with primary hypertension in 14 cities in China.The investigation items included general characteristics,history of diseases,history of drugs and drug-taking behavior.Physical examination included blood pressure,heart rate,height,weight,biochemical test and ECG.Results Of all the participants 69.9% were under treatment.There were 4.8% patients with free medical care,63.2% having the medical insurance,and 30.3% having to pay the medicine at their own expenses.When taking anti-hypertensive agents,only 81.2% patients follow doctor＇s advice.Efficacy,price,adverse effect and convenience were the main influential factors for choosing drugs,while doctor and nurses,family and friends and health education were the main personal factors.Seeking more medical advice,economic and convenience mainly influenced patients to choose the place for drug purchase.58 yuan per month for anti-hypertensive drugs was the highest charge they can accept,and the number of those with high income was higher than that of the patients with low income.Conclusions Price is an important factor for outpatients to choose drugs,so economic reasonable drugs are appropriate for Chinese hypertension patients.It is necessary to strengthen community health education,correct the arbitrariness for drug-taking in part of the patients,and improve the control rate of hypertension in China.