Antihypertensive drug medication adherence and its affecting factors in South Korea
Antihypertensive drug medication adherence and its affecting factors in South Korea
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DOI：
10.1016/j.ijcard.2007.04.114
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发表时间：
2008-08-29
影响因子：
3.5
通讯作者：
Lee, Sang I. I. I.
中科院分区：
文献类型：
--
作者：
Park, Jae-Hyun;Shin, Youngsoo;Lee, Sang I. I. I.
内容：由于服药依从性低而导致的高血压不受控制，可能会导致心血管疾病和中风等严重并发症。目的：估计韩国全国代表性样本的抗高血压药物服药依从性，并确定影响服药依从性的因素。数据来源：我们从几乎覆盖所有韩国人的国民健康保险中获得了索赔数据和强制性资格数据，并确定了那些在2004日历年期间获得抗高血压药物处方的患者。患者：共有2，455，193例患者被纳入研究对象。累积药物依从性（CMA）被用作药物依从性的指标。结果：2，455，193例患者的平均CMA为81.4%。适当依从率（CMA = 80%）为54.7%，CMA <50%者占17.9%。多因素Logistic回归分析显示，女性患者适当服药依从性的概率随年龄的降低而降低，当患者有残疾时，当患者的居住地从一个大城市到另一个大城市时（OR：0.91-0.92），农村地区（OR：0.76-0.78），偏远农村地区（OR：0.72-0.74），每次就诊的处方天数减少，处方医生数量增加。需要在目标人群或社区中识别这些因素，然后制定干预计划以增加抗高血压药物的依从性。同时，本研究所产生的服药依从率可作为国民健康指标及各种高血压控制项目的绩效指标。(C)2007爱思唯尔爱尔兰有限公司保留所有权利。
Context: Uncontrolled hypertension attributable to low medication adherence may cause such serious complications as cardiovascular disease and stroke.Objectives: To estimate adherence to antihypertensive drug medication of the nation's representative sample in South Korea and to identify factors affecting medication adherence.Data sources: We obtained claims data and qualification data of compulsory from the National Health Insurance, which covers almost all Korean, and identified those who got a prescription of antihypertensives during calendar year 2004.Patients: A total of 2,455,193 patients were included as study subjects. Cumulative medication adherence (CMA) was used as an index of medication adherence. Above 80% of CMA was defined as appropriate medication adherence.Results: Average CMA in the total of 2,455,193 patients was 81.4%. Appropriate adherence (CMA = 80%) rate was 54.7% and those whose CMA is below 50% occupied 17.9%. In multiple logistic regression analysis, probability of appropriate medication adherence decreased in female gender, as age decreased, when patients have disability, when patients' residential area were from metropolitan city to city (OR: 0.91-0.92), to rural area (OR: 0.76-0.78), to extreme rural area (OR: 0.72-0.74), prescription days per visit decreased, and the number of prescribing physicians increased.Conclusions: Identifying these factors in a target population or community, followed by developing intervention programs to increase antihypertensive medication adherence is needed. Also, medication adherence rate produced in this study can be used as a national health index and performance indexes of various hypertension control programs. (C) 2007 Elsevier Ireland Ltd. All rights reserved.