高血压患者社会支持、药物治疗依从性与血压控制的关系  

Correlations between society support,treatment compliance and blood pressure control among hypertensive patients

作　　者：亓小燕[1] 戴俊明[1] 尉敏琦[2] 王健[2] 余峰[2] 严玉洁[3] 

机构地区：[1]复旦大学公共卫生学院,公共卫生安全教育部重点实验室,上海200032 [2]上海市闵行区疾病预防控制中心健康教育科 [3]上海市闵行区疾病预防控制中心慢性病防治科

出　　处：《中华高血压杂志》2014年第1期36-41,共6页Chinese Journal of Hypertension

基　　金：国家"十一五"科技支撑计划2009BAI77B06

摘　　要：目的了解高血压患者血压控制现状,探讨高血压患者社会支持、药物治疗依从性与血压控制间的关系。方法 2011年8月至11月,选取上海市某区慢性病管理系统中的高血压患者为调查对象,以调查对象自填问卷的方式完成调查。采用社会支持量表和药物治疗依从性问卷,对患者的社会支持和药物治疗依从性进行评估。结果共调查正在服药的高血压患者1059例,66.2%调查对象血压控制在目标水平(<140/90mm Hg),70.5%调查对象药物治疗依从性佳;正在服药的高血压患者的社会支持总得分为(39.64±7.19)分,主观支持、客观支持和支持利用度得分分别为(24.23±4.73)分、(8.51±2.56)分和(6.91±2.20)分;Spearman等级相关分析显示,支持利用度评分与药物治疗依从性得分明显相关(rs=0.86,P<0.01);多因素分析示支持利用度高(OR1.56,95%CI 1.17~2.07)、高血压病程长(>5~10年:OR1.99,95%CI1.40~2.83;>10年:OR1.44,95%CI 1.03~2.02)、家庭人均月收入高(OR2.10,95%CI1.33~3.30)是药物治疗依从性的保护因素;男性(OR0.58,95%CI 0.44~0.76)、高血压分级高(OR0.33,95%CI 0.16~0.67)是血压控制的危险因素;药物治疗依从性佳(OR1.48,95%CI1.11~1.98)是血压控制的保护因素(均P<0.05)。结论构建有效的社会支持系统,提高患者的社会支持利用度,并着重对高血压病程短、家庭人均月收入低、男性和高血压分级高者进行干预,对进一步提高高血压患者的药物治疗依从性和高血压控制率更有意义。Objective To investigate the current status of blood pressure control, the correlations between society support, treatment compliance （compliance in patient with anti hypertension therapy, CPAT） and blood pressure control among hypertensive patients. Methods The patients were selected from the chronic disease management system of one of districts in Shanghai from August to November in the year 2011. The survey was conducted with self-reported questionnaires containing social support rating scale and Morisky compliance scale. The society sup- port and CPAT were evaluated. Results A total of 1059 patients with antihypertensive therapy were included, 66.2% reached target blood pressure level （〈140/90 mm Hg） , 70.5% had good CPAT. The general score of so ciety support for those who took medication was （39.64± 7.19）, with respective subjective support score, objective support score and support utilization score of （24.23±4.73）, （8.51±2.56） and （6.91±2.20）. The results of Spearman rank correlation analysis showed that society support utilization was significantly correlated with CPAT （rs=0.86, P〈0.01）. Multivariate Logistic analysis showed that high support utilization （OR 1.56, 95%%o CI 1.17--2.07）, long course of hypertension （〉5-10 year： OR 1.99, 95% CI 1.40--2.83; 〉10 year： OR 1.44, 95% CI 1.03--2.02） and high monthly income per capita （OR 2.10; 95% CI 1.33--3.30） were related factors for hetter CPAT, while male{OR 0. 58; 95% CI O. 44-0.76） and high hypertension grade （OR O. 33; 95% CI O. 16--0.67） were risk factors for blood pressure control. Better CPAT {OR 1.48; 95% CI 1.11- 1.98） was a protective factor for blood pressure control （all P^0.05）. Conclusions Establishing comprehensive and effective society support, improving society support utilization level, and intervention in patents with short hypertension course, lower month- ly income per capita, male gender and high hypertension grade would be helpful in increasing CPAT, thus improve blood

关 键 词：高血压 血压控制 社会支持 药物治疗依从性 

分 类 号：R544.1[医药卫生—心血管疾病]