老年高血压患者服药依从性自我报告两种常用问卷适用性分析

Applicability of two commonly used self-reported questionnaires for measuring medication adherence in elderly hypertension patients

目的了解自制问卷和8项Morisky药物依从性量表(MMAS-8)2种常用老年高血压患者服药依从性自我报告问卷的适用性,为临床实践及科研中药物依从性问卷的选择提供参考依据。方法于2017年4—9月采用典型抽样方法在新疆石河子地区抽取3个社区和2个团场共1085例老年高血压患者进行面访问卷调查。结果新疆石河子地区调查的1085例老年高血压患者中,自制问卷和MMAS-8量表2种问卷共同测得服药依从者497例,不依从者364例,两者符合率为79.4%;其中,自制问卷所测高血压患者服药依从率为63.8%,高于MMAS-8量表所测高血压患者服药依从率的48.5%,差异有统计学意义(χ2=416.739,P<0.001)。自制问卷在"您能否按照医嘱要求次数服药"和"您能否按照医嘱服药量服药"2个条目不依从的比例较高,分别为26.7%和23.6%;MMAS-8量表在"您是否有时忘记服用降压药"和"您多久会有一次忘记服用降压药"2个条目不依从的比例较高,分别为32.4%和20.7%。结论新疆石河子地区老年高血压患者总体服药依从性较好;自制问卷和MMAS-8量表2种问卷均可用于老年高血压患者服药依从性的测量,但MMAS-8量表更能测量出老年高血压患者服药依从性的障碍。

Objective To assess the applicability of a medication adherence questionnaire developed by Chinese researchers(MAQ-C)and the Eight-Item Morisky Medication Adherence Scale(MMAS-8)in measuring self-reported medication adherence among the elderly hypertensives and to provide references for selection of medication adherence scale in clinical practice and scientific research.Methods Using typical sampling,we conducted face-to-face interviews among1085 hypertension patients aged 60 years and above in 3 communities and 2 corps farms in Shihezi municipality of Xinjiang Uygur Autonomous Region(Xinjiang)from April to September,2017.Both the MMAS-8-Chinese Version and the MAQ-C were used to collect information on medication adherence of the patients.Results Among all the participants,497 and 364 were assessed as adherence and non-adherence to medication with both the MAQ-C and MMAS-8;the concordance rate for the assessment results of the two instruments was 79%.The medication adherence rate assessed with the MAQ-C was significantly higher than that with the MMAS-8(63.8%vs.48.5%,χ2=416.739;P<0.001).When assessed with the MAQ-C,relatively higher ratios of non-adherence were detected on two inquiry items for having the medication according the frequency and dose prescribed by a doctor(26.7%and 23.6%);whereas,when assessed with the MMAS-8,the two inquiry items with relatively higher non-adherence ratio were not forgetting taking medicine anytime and every time(32.4%and 20.7%).Conclusion Medication adherence of the elderly hypertension patients in Shihezi region of Xinjiang was generally good.Both the MAQ-C and MMAS-8 could be used to measure medication adherence in elderly hypertensive patients,but the MMAS-8 scale is better for assessing hindering factors of medication adherence in elderly patients.