基于横断面研究策略的高血压患者用药依从性相关因素分析

Factors related to medication adherence in patients with hypertension based on cross-sectional study strategy

目的评估已知高血压病例中,患者对高血压并发症的感知风险与用药依从性之间的关系。方法使用结构化的管理问卷收集数据,主要包括基本人口统计信息、吸烟史、获得医疗保健服务的机会、抗高血压治疗的持续时间、同时服用的药物数量以及其对高血压相关并发症的感知风险等信息。同时,研究采用Morisk药物依从性量表(MMAS-8)来测量患者抗高血压药物依从性,采用多元变量logistic回归分析用于识别依从性相关的独立因素。结果近一半(48.8%)的参与者患有不受控制的高血压,超过五分之一(22.3%)的患者抗高血压药物依从性较高。与抗高血压药物依从性高度相关的独立因素是较高的教育水平(OR=1.71,95%CI:1.06~2.75)、从不吸烟(OR=1.62,95%CI:1.06~2.46)、易于获得医疗保健服务(OR=1.91,95%CI:1.10~3.35)、较低的平均治疗持续时间(OR=0.96,95%CI:0.92~0.99)以及较高的高血压相关并发症感知风险(OR=2.34,95%CI:1.52~3.60)。结论高血压相关并发症的高感知风险与抗高血压治疗的依从性显著相关。

Objective To evaluate the relationship between perceived risk of complications of hypertension and medication adherence among patients with known hypertension.Methods Data were collected using a structured administrative questionnaire that mainly included information on basic demographic information,smoking history,access to healthcare services,duration of antihypertensive treatment,number of concurrent medications,and their perceived risk of complications related to hypertension.Morisk Medication Adherence Scale(MMAS-8)was used to measure the patients′antihypertensive medication adherence,and multivariate logistic regression analysis was used to identify independent factors related to adherence.Results Nearly half(48.8%)of the participants had uncontrolled hypertension,and more than one fifth(22.3%)of the patients had high adherence to antihypertensive medication.Independent factors highly associated with antihypertensive medication adherence were higher education level(OR=1.71,95%CI:1.06-2.75),never smoking(OR=1.62,95%CI:1.06-2.46),easy access to health care(OR=1.91,95%CI:1.10-3.35),lower average treatment duration(OR=0.96,95%CI:0.92-0.99),and higher perceived risk of hypertension-related complications(OR=2.34,95%CI:1.52-3.60).Conclusion High perceived risk of hypertension-related complications is significantly correlated with adherence to antihypertensive treatment.