社区高血压合并冠心病患者服药依从性影响因素分析

An analysis of influencing factors in drug compliance of hypertension patients with coronary heart disease in community

目的分析社区高血压合并冠心病患者服药依从性的影响因素。方法随机抽取上海市杨浦区3个社区,采用面对面问卷调查的方式,调查50岁以上高血压合并冠心病患者相关资料,包括社会人口学、疾病状况、服药依从性及健康素养等。采用Morisky服药依从性评分量表(MMAS-8)评价患者的服药依从性,≥6分为依从性高,<6分为依从性低。采用慢性病患者健康素养量表评价患者的健康素养水平,包括信息获取能力、交流互动能力、改善健康意愿和经济支持意愿4个维度。采用多因素logistic回归分析患者服药依从性的影响因素。结果本研究共完成467份有效问卷。患者MMAS-8评分为(6.11±1.66)分;其中,依从性高组255例(54.6%),依从性低组212例(45.4%)。依从性高组患者健康素养量表评分总分及其4个维度评分均高于依从性低组(P<0.05)。多因素logistic回归分析结果显示,健康素养中信息获取能力评分和改善健康意愿评分是高血压合并冠心病患者服药依从性的独立影响因素(P<0.05)。结论提高社区高血压合并冠心病患者的健康素养水平,尤其是获取信息能力和改善健康意愿,可以提高患者的服药依从性。

Objective To analyze the influencing factors in drug compliance of hypertension patients with coronary heart disease(CHD)in community.Methods The relevant data of hypertension patients with CHD over 50 years old living in three communities of Yangpu District of Shanghai were investigated by face-to-face questionnaire,which included social demography,disease status,drug compliance and health literacy.Morisky medication adherence scale(MMAS-8)was used to evaluate the drug compliance.The patient with MMAS-8 score≥6 points was assigned into the high adherence(group H)and the patient with MMAS-8 score<6 points was assigned into the low adherence(group L).The health literacy scale for the patients with chronic diseases was used to evaluate the health literacy level,which included four dimensions of information acquisition ability,communication and interaction ability,willingness to improve health and willingness to provide economic support.Multivariate logistic regression was used to analyze the influencing factors of drug compliance.Results A total of 467 valid questionnaires were completed in the study.The MMAS-8 score was(6.11±1.66)points.A total of 255 cases(54.6%)were with MMAS-8 score≥6 points in group H and 212 cases(45.4%)were with MMAS-8 score<6 points in group L.The total score of the health literacy scale and its four dimension score in group H were higher than those in group L(P<0.05).Multivariate logistic regression analysis showed that the score of information acquisition ability in health literacy and the score of willingness to improve health were the independent influencing factors for drug compliance of the patients with hypertension and CHD(P<0.05).Conclusion Improving the health literacy level of the patients with hypertension and CHD,especially the ability to obtain information and willingness to improve health,can improve the drug compliance of the patients in the community.