心肌梗死伴高血压患者二级预防用药依从性影响因素调查  

Influencing Factors of Medication Compliance of Secondary Prevention Medication in Patients with Myocardial Infarction Complicated with Hypertension

作　　者：钟薇 符杨丽 王玲[1] ZHONG Wei;FU YangH;WANG Ling(Heelihcare Center, Hainan General Hospital, Haikou, Hainan, China 570311)

机构地区：[1]海南省人民医院医疗保健中心

出　　处：《中国药业》2019年第17期88-90,共3页China Pharmaceuticals

基　　金：海南省卫生计生行业科研项目[1501036071A2003]

摘　　要：目的统计医院心肌梗死伴高血压患者对二级预防用药的知晓程度、用药现状及用药依从性,分析影响用药依从性的因素。方法选取2015年10月至2017年2月治疗好转出院的心肌梗死伴高血压患者216例,采用随访和问卷调查的方式统计患者出院后1年内的服药情况及依从性。结果二级预防用药知晓率为50.46%;出院后钙离子拮抗剂、血管紧张素转换酶抑制剂(ACEI)/血管紧张素受体Ⅱ抑制剂(ARB)、他汀类药物、β受体阻滞剂停药率较高,分别为33.85%,25.46%,23.20%,17.61%;35.65%的患者用药依从性不佳,对药物疗程不了解(28.57%)、症状改善后停药(24.68%)、遗忘(18.18%)是用药依从性差的主要原因。单因素分析显示,患者出院后用药依从性与性别、文化程度、是否参保无关(P>0.05),与年龄、月收入、口服药物种类、高血压病程有关(P<0.05);Logistic多因素分析显示,月收入不超过3000元[OR=2.672,95%CI(1.261-5.961)],口服药物种类不少于3种[OR=3.621,95%CI(1.264-7.619)],高血压病程不短于5年[OR=2.862,95%CI(1.136-6.769)],是影响患者的危险因素。结论心肌梗死伴高血压患者对二级预防用药知晓率偏低,用药依从性差;经济条件差、口服药物种类过多、高血压病程长是影响患者院外用药依从性的主要因素。Objective To investigate the degree of awareness,medication status and medication compliance of secondary prevention medication in patients with myocardial infarction complicated with hypertension,and to analyze the influencing factors of medication compliance.Methods Totally 216 patients with myocardial infarction complicated with hypertension treated and discharged from hospital from October2015 to February 2017 were selected. Follow-up and questionnaire survey were used to record the medication status and medication compliance of the patients within one year after discharge. Results The awareness rate of secondary prevention medication was 50. 46%.After discharge,the withdrawal rate of calcium antagonist,angiotensin-converting enzyme inhibitors( ACEI)/angiotensin Ⅱ receptor blocker( ARB),statins and β-blocker were high,which were 33. 85%,25. 46%,23. 20% and 17. 61% respectively. 35. 65% of patients had poor medication compliance,and the main reasons for that were as follows: ignorance of the course of treatment( 28. 57%),withdrawal of drugs after symptoms improved( 24. 68%) and forgetfulness( 18. 18%). Univariate analysis showed that the compliance of the patients after discharge was not related to gender,education level and whether they participated in medical insurance or not( P > 0. 05),while that was related to age,monthly income,kinds of oral drugs and course of hypertension( P < 0. 05). Logistic multivariate analysis showed that monthly income was not more than 3 000 Yuan [ OR = 2. 672,95% CI( 1. 261-5. 961)],kinds of oral drugs were not fewer than three [ OR = 3. 621,95% CI( 1. 264-7. 619)] and the course of hypertension was not shorter than 5 years [ OR = 2. 862,95% CI( 1. 136-6. 769)] were the risk factors for the patients. Conclusion The awareness rate of secondary prevention medication is low,and medication compliance is poor. Poor economic conditions,too many kinds of oral drugs and the long course of hypertension are the main factors affecting the medication compliance of the patients after dis

关 键 词：心肌梗死伴高血压 二级预防用药 知晓程度 用药现状 用药依从性 调查 影响因素 

分 类 号：R952[医药卫生—药学]