终末期肾病降压药与药物依从性的关系分析

Pande Made Desy Ratnasari, Ketut Lia Pran Anggar Yani, Heny Dwi Arini
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摘要

终末期肾病(ESRD)是一种与高血压发病率较高相关的严重肾损害状况,需要降压治疗以防止疾病恶化。因此,接受两种以上抗高血压药物治疗的患者会影响药物依从性。本研究旨在分析ESRD患者抗高血压药物数量与药物依从性的关系。该研究是一项横断面设计,涉及77名参与者,采用有目的抽样技术,于2020年7月至9月在巴厘岛Buleleng私立门诊医院选择。数据收集基于患者的医疗记录和概率药物依从性量表(Probabilistic Medication compliance Scale, ProMAS)问卷。纳入标准为年龄≥18岁、有高血压病史、研究前已服用相同降压药3个月、签署知情同意书、完整病历资料的ESRD患者。一般情况较弱和认知障碍的人被排除在研究之外。数据分析采用Kruskal-Wallis检验。结果显示,总体而言,患者年龄<65岁(80.52%),男性(70.13%),ESRD病程<5年(89.61%),主要为高中(57.14%),无并发症(57.1%)。大多数患者使用两种抗高血压药物联合使用(35.07%),61.04%的患者药物依从性高。降压用药次数与药物依从性无显著相关(p=0.847)。尽管如此,研究仍然表明,ESRD患者抗高血压药物的数量越多,药物依从性越低。
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ANALYSIS BETWEEN THE NUMBER OF ANTIHYPERTENSIVE WITH MEDICATION ADHERENCE IN END STAGE RENAL DISEASE
  End-Stage Renal Disease (ESRD) is a condition of severe renal damage associated with a higher incidence of hypertension that requires antihypertensive therapy to prevent the worsening disease. Therefore, patients who received more than two types of antihypertensives have affected medication adherence. This study aimed to analyze relationship between the number of antihypertensives and medication adherence in ESRD patients. The study was a cross-sectional design involving 77 participants selected by a purposive sampling technique at Outpatient Private Hospital Buleleng Bali in July-September 2020. Data were collected based on patient’s medical records and the Probabilistic Medication Adherence Scale (ProMAS) questionnaire. The inclusion criteria were ESRD patients aged ≥18 years, with hypertension history, taking the same antihypertensive for three months before the study, sign informed consent, and completed medical record data. Those who were a weak general condition and cognitive impairment were excluded from the study. Data were analyzed using a Kruskal-Wallis test. The results showed that overall, of patients were <65 years old (80.52%), male (70.13%), duration of ESRD <5 years (89.61%), primarily high school (57.14%), and without complications (57.1%). Most patients used a combination of two antihypertensives (35.07%), and 61.04% has a high medication adherence. There was no significant relationship between the number of antihypertensives and medication adherence (p=0.847). Nevertheless, it was still shown that the higher number of antihypertensives in ESRD patients was directly proportional to the lower medication adherence.    
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