高血压患者的药物治疗依从性现状及危险因素研究  

Prevalence and Risk Factors for Poor Medication Adherence Among Chinese Hypertensive Patients

作　　者：赵越[1] 戚玮琳[2] 杨爱芳[1] 王斌 钟明康[1] 

机构地区：[1]复旦大学附属华山医院药剂科,上海200040 [2]复旦大学附属华山医院心内科,上海200040

出　　处：《中国药学杂志》2015年第6期559-562,共4页Chinese Pharmaceutical Journal

摘　　要：目的研究高血压患者的药物治疗依从性现状,并且探讨影响高血压患者药物治疗依从性的危险因素,从而为制定有针对性的依从性干预措施打下基础。方法药师通过面对面访谈的形式开展此项横断面研究,利用问卷、量表以及病史记录收集相关数据。结果本项研究共纳入236名高血压患者,其中药物治疗依从性低、中、高的患者分别有62名(占26.3%)、51名(占21.6%)和123名(占52.1%)。在单变量分析中,年龄(P=0.033)、就业情况(P=0.021)、高血压家族史(P=0.016)、患病时间(P=0.002)、合并降脂/抗血小板药物(P=0.001)、记忆力(P<0.001)、医疗负担(P<0.001)、药物副作用(P=0.020)、担忧药物长期不良反应(P=0.024)、药物带来其他问题(P=0.005)、自我效能(P<0.001)等因素显著影响高血压患者的药物治疗依从性。在多因素分析中,高血压患者的患病时间(P=0.006)以及自我效能(P<0.001)为药物治疗依从性的独立危险因素。结论我国高血压患者的药物治疗依从性现状不理想,医疗人员可以根据依从性危险因素有针对性地采取干预措施以改善患者依从性,从而提高血压控制效果。OBJECTIVE To investigate the magnitude of poor medication adherence among Chinese hypertensive patients,and investigate the risk factors associated with antihypertensive medication adherence. METHODS The pharmacist conducted the crosssectional study in a comprehensive teaching hospital via face-to-face interview,using some questionnaires and scales. RESULTS The62（ 26. 3%）,51（ 21. 6%） and 123（ 52. 1%） of the hypertensive patients showed low,moderate and high medication adherence. In the univariate analysis,patients＇ antihypertensive adherence was associated with the factors of age（ P = 0. 033）,employment（ P =0. 021）,family history（ P = 0. 016）,duration of hypertension（ P = 0. 002）,combination of antiplatelet / antilipemic agents（ P =0. 001）,forgetfulness（ P〈0. 001）,medical cost（ P〈0. 001）,side effects（ P = 0. 020）,concerns of long-term effects（ P =0. 024）,other problems caused by drugs（ P = 0. 005）,and self-efficacy（ P〈0. 001）. In the multivariate analysis,the factors of duration of hypertension and self-efficacy were identified to independently affect medication adherence among Chinese hypertensive patients. CONCLUSION Medication adherence among Chinese hypertensive patients is far from optimal,and the pharmacists should take effective interventions to improve patients＇ adherence on the basis of the risk factors.

关 键 词：药物依从性 高血压 危险因素 自我效能 

分 类 号：R95[医药卫生—药学]