老年冠心病患者二级预防用药随访研究

A Follow up Study on Medication Adherence of Secondary Prevention in Elderly Patients with Coronary Artery Disease

目的探讨老年冠心病患者二级预防用药情况及健康教育对老年冠心病患者用药依从性的影响。方法对北京某医院干部门诊和病房确诊为冠心病的患者,随访了解患者的用药状况(1年),然后分批给冠心病患者做"关于冠心病规范治疗,三高达标"等健康教育讲座,并现场答题,发放《就诊信息提示手册》,随访1年,定期收回手册统计用药情况,参考Mofisky-Green(MG)测评表进行服药依从性评判。结果未做健康教育随访1年,冠心病患者二级预防用药依从性佳的百分率为23.9%,多因素Logistic回归分析显示影响用药依从性因素有冠心病合并症情况及患者是否掌握冠心病知识:合并症少、冠心病知识丰富,则服药依从性好。健康教育后随访1年,药物治疗依从性佳的百分率为51.2%,二者之间差异有统计学差异。结论老年冠心病患者服药依从性差,影响用药依从性因素有冠心病合并症情况及患者是否掌握冠心病知识;健康教育可以明显提高老年患者服药依从性,从而提高冠心病控制率。

Objective To analyze the influence of health education on medication adherence in elderly patients with coronary artery disease. Methods From July 2009 to December 2011,208 CAD patients diagnosed in a hospital were followed up for 12 months to determine adherence to evidence-based cardiovascular medications. The influence factors of adherence were also analyzed. After one year of follow-up, health education was carried out by experienced doctors. The patients were followed up for another year. Results One year of follow-up showed that the proportion of patients who were adherent to medication was 23.9% before health education.Logistic regression analysis showed that medication adherence was independently and significantly associated with comprehension about CAD and complications. After one year of health education, the proportion reached to 51.2%. There was significant differences（P〈0.05）. Conclusion Health education can increase medication adherence.