门诊新发高血压患者服药依从性轨迹及影响因素研究
Medication adherence trajectory and its influencing factors in outpatients with new-onset hypertension
路胜男 1李玲 1王甜甜 2王金3
作者信息
- 1. 中国人民解放军总医院海南医院门诊部(海南三亚,572013)
- 2. 中国人民解放军总医院海南医院神经内科(海南三亚,572013)
- 3. 中国人民解放军总医院海南医院综合治疗室(海南三亚,572013)
- 折叠
摘要
目的 探究门诊新发高血压患者服药依从性轨迹及其影响因素,为制定针对性干预措施提供参考.方法 采用便利抽样法选取337例门诊新确诊的高血压患者为研究对象,应用Morisky服药依从性量表于确诊后4周、3个月、6个月和12个月进行4次调查,采用群组化轨迹模型分析患者服药依从性变化轨迹,并通过多分类logistic回归分析其影响因素.结果 患者在4个时间点的服药依从性得分比较,差异无统计学意义(P＞0.05).服药依从性轨迹分为持续高依从性组(52.82％)、中等波动组(37.09％)及持续低依从性组(10.09％)3类.多分类logistic回归分析显示,与持续高依从组相比,年龄51～60岁、服药种类≥3种更易进入中等波动组(均P＜0.05),年龄36～50岁、文化程度大专、家庭人均月收入＜1 000元更易进入持续低依从性组,社会支持有利于提高患者服药依从性(均P＜0.05).结论 门诊新发高血压患者在确诊12个月内服药依从性轨迹呈现相对稳定性特征,但存在显著的群体异质性.医护人员应特别关注持续低服药依从性及依从性波动变化的患者,根据影响因素采取针对性干预措施,以提高患者服药依从性.
Abstract
Objective To explore the trajectory of medication adherence and its influencing factors in outpatients with new-onset hy-pertension,so as to provide a reference for developing targeted intervention.Methods A total of 337 newly diagnosed outpatients with hypertension were selected by convenience sampling method,then they were investigated by utilizing the Morisky Medication Adherence Scale(MMAS-8)at 4 weeks,3 months,6 months and 12 months after diagnosis.The group-based trajectory modeling was used to analyze the participants'medication adherence trajectory,and its influencing factors were explored by utilizing multino-mial logistic regression.Results There was no statistically significant difference in the participants'scores of MMAS-8 at 4 time points(P＞0.05).The medication adherence trajectory was divided into three categories:a continuous high adherence group(52.82％),a moderate fluctuation group(37.09％)and a continuous low adherence group(10.09％).Multivariate logistic regres-sion analysis showed that,compared with the continuous high adherence group,the patients with an age of 51-60 years old and taking three kinds or more medications were more likely to enter into the moderate fluctuation group(both P＜0.05),and the pa-tients with an age of 36-50 years old,educational background of junior college,and per capital monthly income of the family less than 1 000 yuan were prone to enter into the continuous low adherence group,and social support was conducive to improving pa-tients'medication adherence(all P＜0.05).Conclusion The medication adherence trajectory in outpatients with new-onset hyper-tension shows relatively stable characteristics within the first 12 months after diagnosis,but it reveals significant group heteroge-neity.Medical staff should pay special attention to those patients with continuous low medication adherence and fluctuating adhe-rence,and take targeted interventions according to the influencing factors,so as to improve their medication adherence.
关键词
高血压/门诊/服药依从性/纵向研究/轨迹/群组化轨迹模型/社会支持/影响因素Key words
hypertension/outpatient department/medication adherence/longitudinal study/trajectory/group-based tra-jectory modeling/social support/influencing factors引用本文复制引用
出版年
2024
NETL
NSTL
万方数据