Cohort study of medication adherence in older adults (CoSMO): extended effects of Hurricane Katrina on medication adherence among older adults.
Cohort study of medication adherence in older adults (CoSMO): extended effects of Hurricane Katrina on medication adherence among older adults.
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DOI：
10.1097/maj.0b013e318180f175
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发表时间：
2008-08
期刊：
影响因子：
--
通讯作者：
Krousel-Wood MA
中科院分区：
文献类型：
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作者：
Islam T;Muntner P;Webber LS;Morisky DE;Krousel-Wood MA
以前的研究表明，许多高血压患者用完了药物，并且在卡特里娜飓风后难以立即补充药物。卡特里娜飓风对抗高血压药物依从性的长期影响尚未得到很好的描述。2006年8月至2007年9月期间，对2194名完成老年人药物依从性队列研究基线调查的参与者进行了数据分析。根据卡特里娜飓风前的邮政编码，研究人群被分为高和低受影响的地区。低药物依从性定义为8项Morisky药物依从性量表评分小于6分。低依从性的患病率在生活在高和低受影响地区的参与者中相似。对于卡特里娜飓风破坏的住宅大于或小于25%的参与者以及有和没有创伤后应激障碍症状的参与者，药物依从性低的情况相似。在受影响严重的地区，那些自风暴以来已经搬家的人以及那些在风暴后一个月内死亡的朋友或直系亲属的人没有显著的关联。这些因素与低受影响地区的低药物依从性无关。在高度和低度受灾地区，飓风应对自我效能量表得分较低与药物依从性低相关（p <0.05）。卡特里娜飓风对患者坚持服用抗高血压药物的影响在风暴后的第二年是有限的。内在的病人因素，如低应对自我效能，仍然是重要的因素与低依从性。
Previous research indicates that many patients with hypertension ran out of medications and had difficulties getting refills immediately after Hurricane Katrina. The extended effect of Hurricane Katrina on antihypertensive medication adherence is not well characterized. Data were analyzed for 2194 participants who completed the baseline survey for the Cohort Study of Medication Adherence among Older Adults between August 2006 and September 2007. Based on pre-Katrina zip codes, the study population was categorized into high and low affected areas. Low medication adherence was defined as a score less than 6 on the 8-item Morisky Medication Adherence Scale. Prevalence of low adherence was similar among participants living in high and low affected areas. Low medication adherence was similar for participants with greater than or less than 25% of the residence damaged by Hurricane Katrina and for participants with and without symptoms of post-traumatic stress disorder. In high affected areas, non-significant associations were present for those who had moved since the storm and those with a friend or immediate family member who had died in the month following the storm. These factors were not associated with low medication adherence in low affected areas. In both high and low affected areas, lower scores on the hurricane coping self-efficacy scale were associated with low medication adherence (p <0.05). The effect of Hurricane Katrina on patient adherence to antihypertensive medication was limited in the second year following the storm. Intrinsic patient factors, such as low coping self-efficacy, remain important factors associated with low adherence.