ASH Position Paper: Adherence and Persistence With Taking Medication to Control High Blood Pressure
ASH Position Paper: Adherence and Persistence With Taking Medication to Control High Blood Pressure
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DOI：
10.1111/j.1751-7176.2010.00356.x
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发表时间：
2010-10-01
影响因子：
2.8
通讯作者：
DeGeest, Sabina
中科院分区：
文献类型：
--
作者：
Hill, Martha N.;Miller, Nancy H.;DeGeest, Sabina
不坚持服用抗高血压药物，不坚持或不坚持服用抗高血压药物会导致无法控制的高血压、不良的临床结果和可预防的医疗费用。与不依从相关的因素是多层次的，不仅与患者有关，而且与提供者、卫生保健系统、卫生保健组织和社区有关。国家指南委员会呼吁采取更积极的方法来实施已知的改善依从性的战略和已知的技术，以实现系统层面的变革，包括改善提供者和患者之间的沟通。通过支持患者自我管理、患者护理团队方法、技术支持的办公室实践系统、更好的依从性测量方法和减少临床惰性，可能会提高依从性和持久性。将高血压控制纳入强调和改善慢性病预防和管理的卫生保健政策仍然是一项挑战。提出了四种策略：注重临床结果；赋予知情、活跃的患者权力；发展有准备的主动实践团队；并倡导医疗保健政策改革。由于高血压仍然是就诊的最常见原因，现在是时候了。
Nonadherence and poor or no persistence in taking antihypertensive medications results in uncontrolled high blood pressure, poor clinical outcomes, and preventable health care costs. Factors associated with nonadherence are multilevel and relate not only to the patient, but also to the provider, health care system, health care organization, and community. National guideline committees have called for more aggressive approaches to implement strategies known to improve adherence and technologies known to enable changes at the systems level, including improved communication among providers and patients. Improvements in adherence and persistence are likely to be achieved by supporting patient self-management, a team approach to patient care, technology-supported office practice systems, better methods to measure adherence, and less clinical inertia. Integrating high blood pressure control into health care policies that emphasize and improve prevention and management of chronic illness remains a challenge. Four strategies are proposed: focusing on clinical outcomes; empowering informed, activated patients; developing prepared proactive practice teams; and advocating for health care policy reform. With hypertension remaining the most common reason for office visits, the time is now.