Medication persistence rates and factors associated with persistence in patients following stroke: a cohort study.
Medication persistence rates and factors associated with persistence in patients following stroke: a cohort study.
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中风后患者的药物坚持率和与坚持相关的因素：一项队列研究。
DOI：
10.1186/1471-2377-8-25
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发表时间：
2008-07-10
期刊：
影响因子：
2.6
通讯作者：
Flowerdew, Gordon J.
中科院分区：
文献类型：
--
作者：
Lummis, Heather L.;Sketris, Ingrid S.;Gubitz, Gordon J.;Joffres, Michel R.;Flowerdew, Gordon J.
药物不依从性可能高达50%，导致患者结局不佳。中风患者尤其可以从血栓形成、高血压和血脂异常的药物治疗中获益，但药物非持续性的风险很高。分析了2001年1月1日至2002年12月31日期间因卒中入住新斯科舍省哈利法克斯伊丽莎白二世女王健康科学中心的患者。收集的数据包括卒中前功能、卒中亚型、卒中严重程度、患者结局和出院时以及出院后6个月和12个月的药物使用情况。使用多变量逐步logistic回归分析6个月和12个月时的药物持续性以及与6个月时不持续性相关的因素。出院时，420例患者（平均年龄68.2岁，55.7%为男性）平均处方6.4种药物，平均处方药费用为每月167美元。出院时抗高血压（91%）和抗血栓（96%）药物使用频繁，抗高血糖（73%）和抗高血糖（25%）药物使用较少。在中风后6个月和12个月，所有类别的自我报告的持续性都很高（> 90%）。在6个月时药物非持续性的多变量模型中，年龄在65至79岁的人与年龄在80岁或以上的人相比，不太可能持续使用抗高血压药物（比值比（OR）0.11，95%置信区间（CI）0.03-0.39）。与每月药物费用≥ 200美元相比，每月药物费用<90美元或90 -199.99美元与更大的非持久性相关（<90美元的OR 6.74，95%CI 1.32-34.46; 90 -199.99美元的OR 5.25，95%CI 1.14-24.25）。对于抗血栓药物类别，年龄在65至79岁之间的患者非持续性的可能性低于年龄在80岁或以上的患者（OR 0.23，95% CI 0.06-0.81），入院前残疾的患者非持续性的可能性高于非残疾患者（OR 7.01，95% CI 1.66-29.58）。患者在卒中后6个月和12个月报告了高药物持续率。识别与非持久性相关的因素（如年龄较大和既往残疾）将有助于预测哪些患者停药的风险较高。
Medication nonadherence can be as high as 50% and results in suboptimal patient outcomes. Stroke patients in particular can benefit from pharmacotherapy for thrombosis, hypertension, and dyslipidemia but are at high risk for medication nonpersistence. Patients who were admitted to the Queen Elizabeth II Health Sciences Centre in Halifax, Nova Scotia, with stroke between January 1, 2001 and December 31, 2002 were analyzed. Data collected were pre-stroke function, stroke subtype, stroke severity, patient outcomes, and medication use at discharge, and six and 12 months post discharge. Medication persistence at six and 12 months and the factors associated with nonpersistence at six months were examined using multivariable stepwise logistic regression. At discharge, 420 patients (mean age 68.2 years, 55.7% male) were prescribed an average of 6.4 medications and mean prescription drug cost was $167 monthly. Antihypertensive (91%) and antithrombotic (96%) drug use at discharge were frequent, antilipidemic (73%) and antihyperglycemic (25%) drug use were less common. Self-reported persistence at six and 12 months after stroke was high (> 90%) for all categories. In the multivariable model of medication nonpersistence at six months, people aged 65 to 79 years were less likely to be nonpersistent with antihypertensive medications than people aged 80 years or more (Odds ratio (OR) 0.11, 95% Confidence Interval (CI) 0.03–0.39). Monthly drug costs of < $90 or $90–199.99 were associated with greater nonpersistence, compared to monthly drug costs ≥$200 (OR 6.74, 95% CI 1.32–34.46 for < $90; OR 5.25, 95% CI 1.14–24.25 for $90–199.99). For the antithrombotic drug category, people aged 65 to 79 years were less likely to be nonpersistent than people aged 80 years or more (OR 0.23, 95% CI 0.06–0.81), and people who were disabled before admission were more likely to be nonpersistent than those not disabled (OR 7.01, 95% CI 1.66–29.58). Patients reported high medication persistence rates six and 12 months after stroke. Identification of factors associated with nonpersistence (such as older age and prior disability) will help predict which patients are at higher risk for discontinuing their medications.
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影响因子：
8.3
作者：
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通讯作者：
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影响因子：
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作者：
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