Factors associated with medication refill adherence in cardiovascular-related diseases: A focus on health literacy
Factors associated with medication refill adherence in cardiovascular-related diseases: A focus on health literacy
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DOI：
10.1111/j.1525-1497.2006.00591.x
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发表时间：
2006-12-01
影响因子：
5.7
通讯作者：
Rask, Kimberly
中科院分区：
文献类型：
--
作者：
Gazmararian, Julie A.;Kripalani, Sunil;Rask, Kimberly
背景：影响药物依从性的因素尚未完全阐明。健康素养技能不足可能会损害对医疗护理说明的理解，从而降低药物依从性。目的：研究患有心血管相关疾病的 Medicare 管理式护理参保者的健康素养与药物补充依从性之间的关系。研究设计：前瞻性队列研究。主题：来自 4 个管理式护理计划的新 Medicare 参保者完成了现场调查，并通过管理数据确定患有冠心病、高血压、糖尿病糖尿病和/或高脂血症（n=1,549）。 测量：使用成人功能性健康素养测试（S-TOFHLA）的缩写形式确定健康素养。前瞻性管理数据用于计算一年内的累积药物缺口 (CMG)，这是药物补充依从性的有效衡量标准。低依从性定义为 CMG >= 20%。结果：总体而言，40% 的参与者的补充依从性较低。双变量分析表明，健康素养、种族/民族、教育程度和治疗方案复杂性均与药物补充依从性相关（P
BACKROUND: The factors influencing medication adherence have not been fully elucidated. Inadequate health literacy skills may impair comprehension of medical care instructions, and thereby reduce medication adherence.OBJECTIVES: To examine the relationship between health literacy and medication refill adherence among Medicare managed care enrollees with cardiovascular-related conditions.RESEARCH DESIGN: Prospective cohort study.SUBJECTS: New Medicare enrollees from 4 managed care plans who completed an in-person survey and were identified through administrative data as having coronary heart disease, hypertension, diabetes mellitus, and/or hyperlipidemia (n=1,549).MEASURES: Health literacy was determined using the short form of the Test of Functional Health Literacy in Adults (S-TOFHLA). Prospective administrative data were used to calculate the cumulative medication gap (CMG), a valid measure of medication refill adherence, over a 1-year period. Low adherence was defined as CMG >= 20%.RESULTS: Overall, 40% of the enrollees had low refill adherence. Bivariate analyses indicated that health literacy, race/ethnicity, education, and regimen complexity were each related to medication refill adherence (P