Factors associated with adherence to anti-hypertensive treatment in Pakistan.
Factors associated with adherence to anti-hypertensive treatment in Pakistan.
复制标题
与遵守巴基斯坦抗高血压治疗有关的因素。
DOI：
10.1371/journal.pone.0000280
复制
发表时间：
2007-03-14
期刊：
影响因子：
3.7
通讯作者：
Ahmad, Usman
中科院分区：
文献类型：
--
作者：
Hashmi, Saman K.;Afridi, Maria B.;Abbas, Kanza;Sajwani, Rubina A.;Saleheen, Danish;Frossard, Philippe M.;Ishaq, Mohammad;Ambreen, Aisha;Ahmad, Usman
依从性差是高血压治疗控制的最大障碍之一。本研究的目的是（i）测量巴基斯坦高血压人群的代表性样本对抗高血压治疗的依从性，以及（ii）调查与研究人群依从性相关的因素。 2005 年 9 月至 2006 年 5 月，对阿加汗大学医院 (AKUH) 和卡拉奇国家心血管疾病研究所的 460 名患者进行了一项简单随机样本的横断面研究。使用 Morisky 药物依从量表 (MMAS) 评估依从性，评分范围从 0（不依从）到 4（依从）。除了 MMAS 之外，患者自我报告在规定时间内服用的药片数量也被用来估计依从性的百分比。纳入 AKU 焦虑和抑郁量表 (AKU-ADS) 来寻找抑郁与依从性之间的关联。在 80% 的临界值下，77% 的病例坚持治疗。根据单变量分析，年龄的增加、意识的提高和处方药数量的增加显着提高了依从性，而抑郁症则没有显示出相关性。根据多变量分析，显着相关性包括患者服用的药物数量（P<0.02）以及他/她是否定期服用药物或仅用于缓解症状（P<0.00001）。与世界范围内报告的情况类似，年龄较小、意识较差和对症治疗对我国人群抗高血压药物的依从性产生了不利影响。相比之下，单一疗法会降低依从性，而抑郁等社会心理因素则没有显示出相关性。这些发现可用于识别存在低依从性风险的人群子集，他们应该成为干预措施的目标，以实现更好的血压控制，从而预防并发症。
Poor adherence is one of the biggest obstacles in therapeutic control of high blood pressure. The objectives of this study were (i) to measure adherence to antihypertensive therapy in a representative sample of the hypertensive Pakistani population and (ii) to investigate the factors associated with adherence in the studied population. A cross-sectional study was conducted on a simple random sample of 460 patients at the Aga Khan University Hospital (AKUH) and National Institute of Cardiovascular Diseases, Karachi, from September 2005–May 2006. Adherence was assessed using the Morisky Medication Adherence Scale (MMAS), with scores ranging from 0 (non-adherent) to 4 (adherent). In addition to MMAS, patient self-reports about the number of pills taken over a prescribed period were used to estimate adherence as a percentage. AKU Anxiety and Depression Scale (AKU-ADS) was incorporated to find any association between depression and adherence. At a cut-off value of 80%, 77% of the cases were adherent. Upon univariate analyses, increasing age, better awareness and increasing number of pills prescribed significantly improved adherence, while depression showed no association. Significant associations, upon multivariate analyses, included number of drugs that a patient was taking (P<0.02) and whether he/she was taking medication regularly or only for symptomatic relief (P<0.00001). Similar to what has been reported worldwide, younger age, poor awareness, and symptomatic treatment adversely affected adherence to antihypertensive medication in our population. In contrast, monotherapy reduced adherence, whereas psychosocial factors such as depression showed no association. These findings may be used to identify the subset of population at risk of low adherence who should be targeted for interventions to achieve better blood pressure control and hence prevent complications.
登录
查看更多内容
加沙地带中风和高血压患者的心理压力和健康相关生活质量的关联。
影响因子：
3.7
作者：
Baune, B T;Aljeesh, Y
通讯作者：
Aljeesh, Y
影响因子：
4.1
作者：
Cheng, JWM;Kalis, MM;Feifer, S
通讯作者：
Feifer, S
影响因子：
--
作者：
Egan, BM;Lackland, DT;Cutler, NE
通讯作者：
Cutler, NE
影响因子：
1.8
作者：
Gryglewska, B
通讯作者：
Gryglewska, B
影响因子：
12.7
作者：
Monane, M;Boh, RL;Avorn, J
通讯作者：
Avorn, J