习水县高血压患者用药依从性分析  

Analysis of medication compliance of hypertensive in Xishui County

作　　者：谭丹枫 胡仪 王明利 杨宪梅 母小波 田应彪 TAN Dan-feng;HU Yi;WANG Ming-li;YANG Xian-mei;MU Xiao-bo;TIAN Ying-biao(Xishui County People's Hospital,Xishui 564600,China;Department of Pharmacy,Affiliated Hospital of Zunyi Medical University,Zunyi 563003,China)

机构地区：[1]习水县人民医院药剂科,贵州习水564600 [2]习水县人民医院小儿外科,贵州习水564600 [3]习水县人民医院门诊部,贵州习水564600 [4]遵义医科大学附属医院药剂科,贵州遵义563003

出　　处：《社区医学杂志》2022年第20期1141-1145,共5页Journal Of Community Medicine

基　　金：遵义市科技局联合资金项目[遵市科合HZ字(2019)257号]

摘　　要：目的了解习水县高血压患者用药依从性情况及其影响因素,为习水县高血压的综合防治提供依据。方法收集2021年1-12月在习水县慢性病系统登记的1160例≥35岁高血压患者的资料,由经过统一培训的调查员进行电话访问并发放问卷,调查内容包括患者的性别、年龄、文化程度、经济状况、病程、血压控制情况、用药依从性和不依从相关因素等。结果完全按医嘱用药202例(17.41%),不完全按照医嘱用药603例(51.98%),完全不按照医嘱用药355例(30.60%)。血压控制优216例(18.62%),良334例(28.79%),差610例(52.59%),差异有统计学意义(χ^(2)=4.84,P<0.05);12个月随访中,药物覆盖天数比例(PDC)≥80%者仅有94例(8.10%),408例(35.17%)患者PDC<20%。影响用药依从性的因素有认知因素(认为疾病好转而停服药占18.97%,认为药物的疗效不好占25.26%,不知道高血压需要长期坚持服药占10.95%,不知道需要长期门诊复查占3.88%)、生活习惯(忘记服药占22.67%,病程长无法坚持占22.76%,难以改变生活方式占19.48%)、药物因素(药物方案太复杂占14.14%,出现药物不良反应占14.83%)、医疗因素(医疗费用支付方式占20.60%,门诊复查不方便占21.29%)及其他因素(经济原因占12.59%)。结论习水县高血压患者血压控制低,用药依从性低,影响因素与低学历、低收入、用药素养、生活习惯、药物因素、医疗因素等有关,应加强对高血压患者的教育宣传和采取多途径的干预措施,以期最大限度地提高高血压患者的用药依从性。Objective To understand the medication compliance and its influencing factors of hypertensive patients in Xishui County,and to provide a basis for comprehensive prevention and treatment of hypertension in Xishui County.Methods The data of 1160 hypertensive patients≥35 years old who were registered in the chronic disease system of Xishui County from January to December 2021 were collected,and the uniformly trained investigators conducted telephone interviews and distributed questionnaires.The investigation contents included the gender,age,educational level,economic status,course of disease,blood pressure control,medication compliance and non-compliance related factors of the patients.Results There were 202 cases(17.41%)who took medication exactly as prescribed by the doctor,603 cases(51.98%)who didn’t take medication exactly as prescribed,and 355 cases(30.60%)who didn’t take medication as prescribed at all.Blood pressure control was excellent in 216 cases(18.62%),good in 334 cases(28.79%),and poor in 610 cases(52.59%),the difference was statistically significant(χ^(2)=4.84,P<0.05).During the 12 month followed-up,only 94 patients(8.10%)had drug coverage days(PDC)≥80%,and 408 patients(35.17%)had PDC<20%.Factors affecting medication adherence include:cognitive factors(18.97%thought the disease had improved and stopped taking the drug,25.26%thought the drug was ineffective,10.95%did not know that high blood pressure required long-term adherence to the drug,3.88%did not know that long-term outpatient review was required),living habits(22.67%forgetting to take medicine,22.76%unable to adhere to the long course of disease,19.48%difficult to change lifestyle),drug factors(drug regimen was too complicated 14.14%,adverse drug reactions 14.83%),medical factors(medical expenses payment method 20.60%,inconvenience of outpatient review 21.29%)and other factors(economic reasons 12.59%).Conclusions Hypertensive patients in Xishui County have low blood pressure control and low medication compliance.The influencing factors

关 键 词：高血压 用药依从性 调查分析 干预 习水县 

分 类 号：R544.1[医药卫生—心血管疾病]