Patient-reported adherence to guidelines of the Sixth Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
Patient-reported adherence to guidelines of the Sixth Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
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DOI：
10.1592/phco.21.9.828.34557
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发表时间：
2001-07-01
期刊：
影响因子：
4.1
通讯作者：
Feifer, S
中科院分区：
文献类型：
--
作者：
Cheng, JWM;Kalis, MM;Feifer, S
目标。比较抗高血压药物的依从性与第六届全国高血压预防、检测、评估和治疗联合委员会 (JNC VI) 制定的治疗指南，并确定患者对抗高血压药物的依从性和影响处方模式的因素。方法。纳入了在纽约大都会地区药房填写抗高血压药物处方的患者。药房实习生收集患者报告的人口统计数据、医疗和药物史以及血压测量值。评估了 JNC VI 指南的遵守情况。结果。来自 102 家药房的 821 名患者参与了研究。研究时 61% 的患者血压得到控制。最常用的抗高血压药物是血管紧张素转换酶抑制剂，其次是利尿剂和β受体阻滞剂。在研究期间，JNC VI 指南的依从性从 85% 显着下降至 64% (p < 0.05)。百分之三十七的患者报告始终坚持其抗高血压治疗方案。患者的教育水平是唯一被发现与处方抗高血压药物的适当性呈正相关的因素。结论。随着时间的推移，对 JNC VI 指南的依从性逐渐下降，患者对药物治疗的依从性也不理想。加强最佳血压管理的继续教育工作是必要的。
Objectives. To compare antihypertensive drug compliance with treatment guidelines established by the Sixth joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI), and to identify patient adherence to antihypertensive drugs and factors affecting prescribing patterns.Methods. Patients filling antihypertensive drug prescriptions in metropolitan New York area pharmacies were enrolled. Pharmacy externs collected patient-reported demographics, medical and drug histories, and blood pressure measurements. Compliance with JNC VI guidelines was assessed.Results. Eight hundred twenty-one patients from 102 pharmacies participated. Blood pressure was controlled in 61% of patients at the time of the study. The most prescribed class of antihypertensive agents was angiotensin-converting enzyme inhibitors, followed by diuretics and beta -blockers. Over the study period, compliance with JNC VI guidelines decreased significantly from 85% to 64% (p < 0.05). Thirty-seven percent of patients reported consistent adherence to their antihypertensive regimens. Patients' education level was the only factor found to correlate positively with the appropriateness of antihypertensive agents prescribed.Conclusion. Compliance with JNC VI guidelines decreased over time, and patient adherence to drug therapy was suboptimal. Continuing-education efforts to reinforce optimal blood pressure management are necessary.