越南高血压患者的药物使用和依从性:一项前瞻性研究

S. T. Pham, Yen T. N. Dang, Thanh V. Vo, H. Y. Tran, Thang Nguyen
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引用次数: 0

摘要

目的:记录患者的抗高血压药物,确定他们的药物依从性,并确定和依从性相关的因素。材料和方法:对越南灿通一组有社会健康保险的高血压门诊患者进行前瞻性研究。这项研究包括330名18岁以上的患者,他们同意参与,可以用越南语听、说和回答问题。数据收集方法基于处方和患者访谈。使用描述性统计学和泊松对数线性分布的广义估计方程对数据进行分析。结果:在药物使用特征中,76.1%的患者开了β受体阻滞剂,91.5%的患者接受了多种治疗,63.0%的患者在第三次随访时更换了药物。坚持服药的患者比例在70.0%至91.2%之间。改善药物依从性的因素包括:高中或更高的学术水平(增加39.0%)、居住在城市地区(增加15.0%)、有与社会交往相关的工作(11.2%)和有高血压家族史(增加9.0%)。降低依从性的因素包括:高龄(减少22.0%)、病程延长(减少16.0%)、治疗时间延长(减少11.0%)和至少一种降压药物的变化(减少8.0%)。结论:本研究的重点是证明了依从率与随访次数之间的反比关系:随访次数越高,依从率越低。第三次随访的依从率为70.0%,依从率下降与年龄较大、教育水平较高和治疗时间较长有关。
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Medication Use and Adherence in Patients with Hypertension: A Prospective Study in Vietnam
Objective: to document patients’ antihypertensive agents, determine their medication adherence, and identify factors associated with the adherence. Material and Methods: A prospective study was performed on a group of hypertensive outpatients, with social health insurance, in Can Tho, Vietnam. The study included 330 patients over 18 years old, who agreed to participate and could listen, speak and answer questions in Vietnamese. The data collection method was based on prescriptions and patient interviews. Data were analyzed using descriptive statistics, and Generalized Estimating Equations with Poisson-log linear distribution. Results: Among the drug use characteristics, 76.1% were prescribed beta-blockers, 91.5% polytherapy, and 63.0% changed drugs at the third follow-up visit. The percentage of patients who adhered to medication ranged from 70.0% to 91.2%. Factors that improved drug adherence included: the academic level at high school or higher (39.0% increase), living in urban areas (15.0% increase), having a job related to social interaction (11.2%), and having a family history of hypertension (9.0% increase). Factors that reduced adherence included: advanced age (22.0% decrease), prolonged disease duration (16.0% decrease), prolonged treatment duration (11.0% decrease), and changes in at least one type of antihypertensive drug (8.0% decrease). Conclusion: The highlight of this study is the demonstration of an inverse relationship between the adherence rate and the number of follow-up visits: the higher the number of visits, the lower the adherence rate. The 3rd follow-up adherence rate was 70.0%, and the decreased adherence rate is related to older age, higher education levels, and a longer duration of treatment.
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