高血压共病糖尿病患者服药依从性调查及影响因素分析

Analysis of medication adherence and influencing factors in hypertensive patients combined with diabetes mellitus

目的了解高血压共病糖尿病患者服药依从性现状,并从社会人口学特征、生活行为方式、疾病资料方面探讨其影响因素。方法于2021年11月—2022年3月,在宁波市4家社区医院随机抽取高血压共病糖尿病患者共381例,参考中文版8条目Morisky服药依从性量表(MMAS-8)自行设计问卷进行调查。采用多因素logistic回归分析研究高血压共病糖尿病患者服药依从性的影响因素。结果381例高血压共病糖尿病患者服药依从性得分为(5.67±1.05)分,依从性高者163例(42.78%)。单因素分析结果显示,高血压共病糖尿病患者服药依从性在性别、医疗付费方式、日服药种类、日服药次数以及是否饮酒方面比较,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,使用城镇职工医保付费(OR=2.141,95%CI:1.346~3.405,P=0.001)的高血压共病糖尿病患者服药依从性较高,日服药次数≥3次(OR=0.438,95%CI:0.208~0.921,P=0.030)、日服药种类≥3种(OR=0.342,95%CI:0.216~0.540,P<0.001)的高血压共病糖尿病患者服药依从性较低。结论高血压共病糖尿病患者服药依从性整体不高,其主要影响因素包括日服药次数、日服药种类、医保付费方式。应针对这些影响因素采取有效措施进行积极干预。

Objective The study aimed to assess the medication compliance status in hypertensive patients combined with diabetes mellitus and to explore the influencing factors based on socio-demographic characteristics,lifestyle behaviors,and medical records.Methods Between November 2021 and March 2022,a total of 381 patients from four community hospitals in Ningbo were randomly selected as participants.They were surveyed using a questionnaire based on the Chinese version of the 8-item Morisky medication adherence scale(MMAS-8).Binary logistic analysis was used for data analysis.Results The average medication adherence score for 381 patients combined hypertension and diabetes mellitus was(5.67±1.05)points,with 163 patients(42.78%)demonstrating high adherence.Univariate analysis revealed that significant associations between medication adherence and various factors,including gender,medical payment methods,daily medication types,daily medication frequency,and alcohol consumption(P<0.05).Multiple logistic regression revealed that patients with medical insurance for urban workers payment had higher medication compliance(OR=2.141,95%CI:1.346-3.405,P=0.001).Additionally,patients with a daily medication frequency of≥3(OR=0.438,95%CI:0.208-0.921,P=0.030)and those with daily medication types≥3(OR=0.342,95%CI:0.216-0.540,P<0.001)exhibited lower medication compliance.Conclusion The medication compliance among patients with combined hypertension and diabetes mellitus is suboptimal,primarily influenced by factors such as daily medication frequency,daily medication types,and medical payment methods.Therefore,proactive interventions should be implemented based on these influencing factors.