杭州市余杭区社区管理高血压病患者不同服药情况对血压控制的影响

Impact of medication compliance among community managed hypertension patients in Yuhang district,Hangzhou

目的探索高血压病患者不同服药情况对血压控制的影响,为防治对策提供依据。方法利用2009年杭州市余杭区4个示范社区高血压病患者随访记录。按照年度内服药时间和血压测定结果,服药分规则、间断、偶治;血压控制分优良、尚可、不良。分析不同服药时间的长、短,对血压控制的效果影响。对有关数据进行χ2检验,P<0.05为差异有统计学意义。结果共调查社区管理的高血压病病患者800例,规则服药率66.2%,影响规则服药依从性的主要与个体的患病年限有关,而性别、年龄差异无统计学意义。高血压病患者血压控制率为64.4%,规则和不规则服药患者的血压控制率分别为79.8%和34.1%,差异有统计学意义(P<0.01,RR=2.34)。结论坚持规则服药对高血压病患者的血压控制是必要的,社区随访中提高患者规则服药依从性对血压控制具有重要意义。

Objective To explore the impact of medication compliance among community managed hypertensive patients.Methods The records of 2009 hypertensive patients and follow-up visits were collected in the four demonstration communities of Yuhang district,Hangzhou city.We analyzed the association of blood pressure control and the pattern of medication compliance.The medication compliance was categorized into taking medication regularly,non-regularly and occasionally.The control of blood pressure was evaluated as apparent,effective and ineffective.Results 800 community managed hypertensive patients were included in the study.66.2% of patients took medication regularly.There was no significant age or sex difference in medication compliance.However,the patients with 5 years history of hypertensive condition or more had better medication compliance than those with less than 5 years of hypertension（P〈0.05）.Blood pressure was well controlled for 64.4% of patients in general.Blood pressure was well controlled in 79.8% of patients with medication adherence,while that only in 34.1% of patients with irregular medication（RR=2.34,P〈0.01）.Conclusion Adherence to medication is important for patients with hypertension.Community management efforts should be given to improve patient medication compliance.