Adherence to medication according to sex and age in the CHARM programme
Adherence to medication according to sex and age in the CHARM programme
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DOI：
10.1093/eurjhf/hfp142
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发表时间：
2009-11-01
影响因子：
18.2
通讯作者：
Swedberg, Karl
中科院分区：
文献类型：
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作者：
Granger, Bradi B.;Ekman, Inger;Swedberg, Karl
虽然许多心力衰竭患者不完全遵守处方药，但诱发因素尚不清楚。该分析调查了与坚持相关的因素，特别强调年龄和性别。对来自CHARM试验的7599例心力衰竭患者进行多变量回归分析，以评估与依从性相关的因素。依从性以患者服用研究药物超过80%的时间比例来衡量。平均年龄为66岁（SD 11），女性占31.5% （n = 2400）。女性的依从性略低于男性（87.3比89.8%,P = 0.002），即使在调整后的多变量模型中（治疗，P = 0.006；安慰剂P = 0.004；总P < 0.001）。然而，女性的全因死亡率（21.5%）低于男性（25.3%）（校正风险比为0.77；95% CI为0.69-0.86;P < 0.001），但无论性别，低依从性患者的死亡率较高。年龄、心力衰竭的严重程度、药物数量和吸烟状况与依从性无关。在有症状性心力衰竭的大样本患者中，女性，尤其是年龄< 75岁的女性，坚持治疗的可能性较小。了解与依从性相关的因素可能为干预提供机会。
Although many patients with heart failure have incomplete adherence to prescribed medications, predisposing factors remain unclear. This analysis investigates factors associated with adherence, with particular emphasis on age and sex.A multivariable regression analysis of 7599 heart failure patients from the CHARM trial was done to evaluate factors associated with adherence. Adherence was measured as the proportion of time patients took more than 80% of study medication. The mean age was 66 years (SD 11) and 31.5% (n = 2400) were women. Women were slightly less adherent than men (87.3 vs. 89.8%, P = 0.002), even in adjusted, multivariable models (treatment, P = 0.006; placebo P = 0.004; and overall P < 0.001). However, all-cause mortality was lower in women (21.5%) than in men (25.3%) (adjusted hazard ratio, 0.77; 95% CI, 0.69-0.86; P < 0.001), but patients with a low adherence regardless of sex had a higher mortality. Age, severity of heart failure, number of medications, and smoking status were not associated with adherence.Women, particularly those < 75 years of age, were less likely to be adherent in this large sample of patients with symptomatic heart failure. Understanding factors associated with adherence may provide opportunities for intervention.