Influencing Factors of Medication Adherence in Patients with Cirrhosis Combined with Hypertension and Its Relationship with Health Literacy
Objective To analyze the influencing factors of medication adherence in patients with cirrhosis combined with hypertension,and to investigate the relationship of medication adherence with health literacy.Methods A total of 125 patients with cirrhosis and hypertension admitted to the hospital from July 2022 to December 2023 were selected.The Morisky Medication Adherence Scale-8(MMAS-8)was used to evaluate medication adherence,and the univariate analysis and multivariate binary Logistic regression model were used to analyze the influencing factors of patients'medication adherence.The All Aspects of Health Literacy Scale(AAHLS)was used to assess health literacy,the Beliefs about Medical Questionnaire(BMQ)was used to assess medication beliefs,and the health literacy and medication beliefs in patients with different medication adherence were compared;a multivariate binary Logistic regression model was constructed,the bias-corrected percentile Bootstrap method was used to analyze the mediating effect of medication beliefs.Results A total of 80,45 patients were included in the high adherence group(MMAS-8 score of 7-8 points)and the low adherence group(MMAS-8 score of 0-＜7 points),respectively.Univariate analysis showed that the age,albumin level,creatinine level,educational level,medication type,medication frequency and occurrence of adverse reactions or not between the two groups were significantly different(P＜0.05).Logistic regression analysis showed that ≥three types of medication and occurrence of adverse reactions were the risk factors affecting medication adherence in patients with cirrhosis and hypertension(P＜0.05).There was a significant difference in health literacy level between the two groups(P＜0.001);the necessary belief score in the high adherence group was(22.33±1.52)points,which was significantly higher than(20.33±2.66)points in the low adherence group,the concern belief score was(18.81±2.05)points,which was significantly lower than(22.21±1.23)points in the low adherence group(P＜0.001).Models Ⅰ-Ⅳ showed that patients with high health literacy had higher necessary beliefs,lower concern beliefs and higher medication adherence(P＜0.05);the absolute value of the standardized regression coefficient for concern beliefs(0.265)was significantly greater than that for necessary beliefs(0.187),and the mediating effect of concern beliefs(Effect=0.074)was greater than that of necessary beliefs(Effect=0.045).Conclusion Medication adherence in patients with cirrhosis and hypertension is related to ≥ three types of medication and the occurrence of adverse reactions.Health literacy affects patients'medication beliefs;for the patients with low health literacy,the medication beliefs should be intervened,with a focus on decreasing concern beliefs to improve medication adherence.
万方数据
维普
