不同年龄段高血压患者服药依从性调查及影响因素

Abstract

目的为了解北京市顺义区高血压患者服药依从性现状以及影响各年龄段高血压患者服药依从性的主要因素,为将来针对不同年龄段高血压患者制订有效干预措施提供参考依据。方法在北京市顺义区随机选取8个社区卫生服务中心,纳入符合标准的596例高血压居民作为调查对象,根据不同的年龄分成A组(<50岁)、B组(50～59岁)、C组(≥60岁),采用自行设计的调查问卷及体格测量表对调查对象进行面对面问卷调查和体格测量。结果高血压患者服药依从性低、中、高的比例分别为30.37%、35.40%和34.23%。3组调查对象服药依从性之间的差异有统计学意义(χ~2=9.030,P<0.05)。有序多分类Logistic回归分析发现:自我效能得分(OR=3.404,95%CI:0.473～1.977)和人均月收入(<2 500元:OR=0.070,95%CI:-4.305～-1.024;2 500元～:OR=0.075,95%CI:-4.543～-0.647)是A组服药依从性分级的影响因素;自我效能得分(OR=3.171,95%CI:0.752～1.556)、其他常见慢性病服药(OR=0.620,95%CI:-0.942～-0.014)和健康素养阅读理解能力(OR=1.236,95%CI:0.009～0.415)是B组服药依从性分级的影响因素;自我效能得分(OR=2.210,95%CI:0.382～1.204)、个人成功经验(OR=0.486,95%CI:-1.120～-0.322)和高血压服药史(OR=0.498,95%CI:-1.342～-0.053)是C组服药依从性分级的影响因素,其中自我效能得分是3组调查对象的共同影响因素,自我效能得分越高,服药依从性分级越高。结论不同年龄段高血压患者服药依从的影响因素具有不同的特点,在开展社区高血压的综合防控中应对不同年龄段的高血压患者进行针对性的干预。

Objective To understand the status of drug compliance in hypertension patients and the main factors affecting the compliance of hypertension patients in all ages in Shunyi District, and to provide an objective reference for the community to develop effective interventions for patients with hypertension of different age. Methods Eight community health service centers were randomly selected in Shunyi District, Beijing. A total of 596 patients with hypertension who met the criteria were included as subjects. According to different ages the subjects were divided into group A(<50 years), group B(50～59 years), and group C(aged 60 years). Face-to-face questionnaires and physical measurements were used in this investigation. Results The proportions of drug compliance in patients with hypertension were 30.37%, 35.40%, and 34.23%, respectively, in the three groups. There was a significant difference in the compliance between the three groups of subjects(χ~2=9.030, P<0.05). Ordinal multi-class Logistic regression analysis found that self-efficacy score(OR=3.404, 95% CI:0.473～1.977) and per-capita monthly income(<2500:OR=0.070,95% CI:-4.305～-1.024,2500～:OR=0.075, 95% CI:-4.543～-0.647) were the influencing factors of drug adherence grading in group A. Self-efficacy score(OR=3.171, 95% CI:0.752～1.556), other common chronic diseases medication(OR=0.620, 95% CI:-0.942～-0.014) and health reading comprehension ability(OR=1.236, 95% CI:0.009～0.415) were the influencing factors of drug adherence grading in group B. Self-efficacy score(OR=2.210, 95% CI:0.382～1.204), personal experience(OR=0.486, 95% CIl:-1.120～-0.322) and hypertension medication history(OR=0.498, 95% CI:-1.342～-0.053) were the influence factors of compliance grading in group C. The self-efficacy score was the common influence factor of the three groups. The higher the self-efficacy score, the higher the compliance grade was. Conclusion The influencing factors of medication compliance in patients with hypertension in different ages had different characteristics. In the comprehensive prevention and control of community hypertension, specific intervention measures should be carried out for patients with hypertension in different ages.