老年高血压患者用药依从性影响因素分析

摘要

Objective To know the medication compliance in elderly patients with hypertension,to analyze the influence factors of medication compliance,and to propose forward intervention countermeasures.Methods The treatment of hypertension in elderly patients was investigated by questionnaire survey.Medication compliance and influence factors were analyzed.Results 166 cases with poor medication compliance,and the rate was 45.0％; 203 cases with good medication compliance,and the rate was 55.0％.It's showed significantly difference on degree of education between the observation group and control group (x2 =12.071,P=0.002).The proportion of peasant and worker was higher in the observation group than control group (78.9％ vs.62.1％,x2 =12.817,P=0.002).The smoker (48.8％) and drinker (59.0％) in observation group more than smoker (27.1％) and drinker (31.0％) in control group(x2=18.481,P＜0.001; x2=29.115,P＜ 0.001).The ratio of payout of-pocket for healthcare was higher in the observation group (21.1％) than control group (9.9％) (x2=9.084,P=0.003).The duration of hypertension was longer in the observation group (8.8±4.6) than control group (6.0±4.1) (t=1.806,P=0.036).The income per month was less in the observation group (1850±150) than control group (2150±200) (t=5.799,P＜ 0.001).There were regression relationship between medication compliance and degree of education,medical security and duration of hypertension.Conclusions According to the influence factors of medication compliance in elderly hypertensive patients,it's useful to improve medication compliance by enhancing health education and designing a personal treatment.%目的 了解老年高血压患者用药依从性状况,分析其影响因素,提出相应干预对策.方法 选择本院369例老年高血压患者为研究对象,采用Morisky Green测评表进行依从性评定,将依从性好的患者作为对照组,依从性差的患者作为观察组.采用问卷调查方式,调查老年高血压患者用药治疗情况,分析用药依从性及其影响因素. 结果 用药依从性差的患者(观察组)166例,占45.0％;用药依从性好的患者(对照组)203例,占55.0％.观察组文化程度明显低于对照组文化程度(x2 =12.071,P=0.002);观察组农民和工人构成比(78.9％)明显高于对照组农民和工人构成比(62.1％)(x2=12.817,P=0.002);观察组患者吸烟(48.8％)和饮酒构成比(59.0％)明显高于对照组吸炯(27.1％)和饮酒构成比(31.0％)(x2=18.481,P＜0.001;x2=29.115,P＜0.001);观察组患者自费医疗比例(21.1％)明显高于对照组自费医疗比例(9.9％)(x2 =9.084,P=0.003);观察组患者病程(8.8±4.6)年明显比对照组病程(6.0±4.1)年长(t=1.806,P=0.036);观察组患者月收入(1850±150)元明显低于对照组月收入(2150±200)元(t=5.799,P＜0.001).用药依从性与患者的文化程度、医疗保障状况和病程有回归关系. 结论 针对老年高血压患者用药依从性影响因素,医务工作者应加强健康教育宣传,设计个性化的治疗计划,从而提高患者用药依从性.