PDF(Pubmed)
Abstract：
BACKGROUND: Nonadherence to antihypertensive treatment is one of the main causes of the lack of blood pressure (BP) control. The coronavirus disease (COVID-19) pandemic imposes substantial social restriction impairing the medical care routine, which may influence adherence to the antihypertensive treatment. To assess the rate of nonadherence to antihypertensive drug treatment during the COVID-19 pandemic.
METHODS: This is a cross-sectional study evaluating hypertensive adult patients from a tertiary outpatient clinic. From March to August 2020, patients were interviewed by telephone during the social distancing period of the COVID-19 pandemic. We evaluated biosocial data, habits, attitudes, and treatment adherence using the 4-item Morisky Green Levine Scale during the social distancing. Uncontrolled BP was defined by BP ≥ 140/90 mmHg. Clinical and prescription variables for drug treatment were obtained from the electronic medical record. We performed a multivariate analysis to determine the predictors of nonadherence to BP treatment.
RESULTS: We studied 281 patients (age 66 ± 14 years, 60.5% white, 62.3% women, mean education of 9.0 ± 4 years of study). We found that 41.3% of the individuals reported poor adherence to antihypertensive drug treatment and 48.4% had uncontrolled BP. Subsample data identified that adherence was worse during the pandemic than in the previous period. The variables that were independently associated with the nonadherence during the pandemic period were black skin color (odds ratio [OR], 2.62; 95% confidence interval [CI], 1.46-4.68), and intermittent lack of access to antihypertensive medication during the pandemic (OR, 2.56; 95% CI, 1.11-5.89).
CONCLUSIONS: Beyond traditional variables associated with poor adherence, the lack of availability of antihypertensive medications during the study underscore the potential role of pandemic on hypertension burden.
METHODS: This is a cross-sectional study evaluating hypertensive adult patients from a tertiary outpatient clinic. From March to August 2020, patients were interviewed by telephone during the social distancing period of the COVID-19 pandemic. We evaluated biosocial data, habits, attitudes, and treatment adherence using the 4-item Morisky Green Levine Scale during the social distancing. Uncontrolled BP was defined by BP ≥ 140/90 mmHg. Clinical and prescription variables for drug treatment were obtained from the electronic medical record. We performed a multivariate analysis to determine the predictors of nonadherence to BP treatment.
RESULTS: We studied 281 patients (age 66 ± 14 years, 60.5% white, 62.3% women, mean education of 9.0 ± 4 years of study). We found that 41.3% of the individuals reported poor adherence to antihypertensive drug treatment and 48.4% had uncontrolled BP. Subsample data identified that adherence was worse during the pandemic than in the previous period. The variables that were independently associated with the nonadherence during the pandemic period were black skin color (odds ratio [OR], 2.62; 95% confidence interval [CI], 1.46-4.68), and intermittent lack of access to antihypertensive medication during the pandemic (OR, 2.56; 95% CI, 1.11-5.89).
CONCLUSIONS: Beyond traditional variables associated with poor adherence, the lack of availability of antihypertensive medications during the study underscore the potential role of pandemic on hypertension burden.
摘要：
背景：不坚持抗高血压治疗是血压（BP）控制不足的主要原因之一。冠状病毒病（COVID-19）大流行施加了严重的社会限制，损害了医疗常规，这可能会影响抗高血压治疗的依从性。评估COVID-19大流行期间不遵守抗高血压药物治疗的比率。
方法：这是一项横断面研究，评估三级门诊的成年高血压患者。2020年3月至8月，在COVID-19大流行的社交距离期间，患者接受了电话采访。我们评估了生物社会数据，习惯,态度，在社交距离期间使用4项MoriskyGreenLevine量表和治疗依从性。未控制的BP定义为BP≥140/90mmHg。从电子病历中获得药物治疗的临床和处方变量。我们进行了多变量分析，以确定不坚持BP治疗的预测因素。
结果：我们研究了281例患者（年龄66±14岁，60.5%白色,62.3%女性，平均教育时间为9.0±4年)。我们发现，41.3％的个体报告对抗高血压药物治疗的依从性差，48.4％的个体血压不受控制。子样本数据表明，大流行期间的依从性比前一时期差。在大流行期间，与不依从性独立相关的变量是黑色肤色(比值比[OR]，2.62；95%置信区间[CI]，1.46-4.68),大流行期间间歇性缺乏抗高血压药物(OR，2.56；95%CI，1.11-5.89）。
结论：除了与依从性差相关的传统变量之外，研究期间缺乏抗高血压药物,这凸显了大流行对高血压负担的潜在作用.
方法：这是一项横断面研究，评估三级门诊的成年高血压患者。2020年3月至8月，在COVID-19大流行的社交距离期间，患者接受了电话采访。我们评估了生物社会数据，习惯,态度，在社交距离期间使用4项MoriskyGreenLevine量表和治疗依从性。未控制的BP定义为BP≥140/90mmHg。从电子病历中获得药物治疗的临床和处方变量。我们进行了多变量分析，以确定不坚持BP治疗的预测因素。
结果：我们研究了281例患者（年龄66±14岁，60.5%白色,62.3%女性，平均教育时间为9.0±4年)。我们发现，41.3％的个体报告对抗高血压药物治疗的依从性差，48.4％的个体血压不受控制。子样本数据表明，大流行期间的依从性比前一时期差。在大流行期间，与不依从性独立相关的变量是黑色肤色(比值比[OR]，2.62；95%置信区间[CI]，1.46-4.68),大流行期间间歇性缺乏抗高血压药物(OR，2.56；95%CI，1.11-5.89）。
结论：除了与依从性差相关的传统变量之外，研究期间缺乏抗高血压药物,这凸显了大流行对高血压负担的潜在作用.
