PDF(Pubmed)
Abstract：
BACKGROUND: This pilot study aimed to investigate medication nonadherence among Taiwanese patients with diabetes, hypertension, and hyperlipidemia using the Chinese version of the Two-Part Medication Nonadherence Scale (C-TPMNS) and the National Health Insurance (NHI) Medicloud system. The study revealed insights into the factors contributing to nonadherence and the implications for improving patient adherence to medications for chronic conditions. However, the small sample size limits the generalizability of the findings. Additionally, the study identified the need for further research with larger and more diverse samples to validate the preliminary findings.
METHODS: The study conducted surveys individuals in central Taiwan who received three-high medications and those who returned expired medications from chain pharmacies. A structured questionnaire including the C-TPMNS was administered, and additional data on medical history and HbA1c, LDL, and blood pressure levels were collected from the NHI Medicloud system. Data analysis was performed using multiple ordered logistic regression and Wald test methods. Setting interpretation cutoff point to determine medication nonadherence.
RESULTS: The study found that 25.8% of participants were non-adherent to prescribed medications. Non-adherent individuals had significantly higher systolic blood pressure (SBP ≥ 140 mmHg) than adherent participants. Non-adherence was also associated with factors such as lower education, single status, living alone, abnormal glucose postprandial concentration, and triglyceride levels. The C-TPMNS demonstrated good reliability (Cronbach\'s alpha = 0.816) and validity (area under the ROC curve = 0.72).
CONCLUSIONS: The study highlighted the complexity of medication nonadherence with diverse determinants and emphasized the importance of tailored interventions. The findings underscored the need for region-specific research to comprehensively address medication nonadherence, especially focusing on adherence to medications for hypertension, hyperlipidemia, and diabetes. The study also identified the need for larger, more diverse studies to validate and expand upon the initial findings and emphasized the importance of pharmacist interventions and patient empowerment in managing chronic conditions and improving overall health outcomes.
METHODS: The study conducted surveys individuals in central Taiwan who received three-high medications and those who returned expired medications from chain pharmacies. A structured questionnaire including the C-TPMNS was administered, and additional data on medical history and HbA1c, LDL, and blood pressure levels were collected from the NHI Medicloud system. Data analysis was performed using multiple ordered logistic regression and Wald test methods. Setting interpretation cutoff point to determine medication nonadherence.
RESULTS: The study found that 25.8% of participants were non-adherent to prescribed medications. Non-adherent individuals had significantly higher systolic blood pressure (SBP ≥ 140 mmHg) than adherent participants. Non-adherence was also associated with factors such as lower education, single status, living alone, abnormal glucose postprandial concentration, and triglyceride levels. The C-TPMNS demonstrated good reliability (Cronbach\'s alpha = 0.816) and validity (area under the ROC curve = 0.72).
CONCLUSIONS: The study highlighted the complexity of medication nonadherence with diverse determinants and emphasized the importance of tailored interventions. The findings underscored the need for region-specific research to comprehensively address medication nonadherence, especially focusing on adherence to medications for hypertension, hyperlipidemia, and diabetes. The study also identified the need for larger, more diverse studies to validate and expand upon the initial findings and emphasized the importance of pharmacist interventions and patient empowerment in managing chronic conditions and improving overall health outcomes.
摘要：
背景：这项初步研究旨在调查台湾糖尿病患者的药物依从性，高血压,使用中文版的两部分药物不依从性量表（C-TPMNS）和国家健康保险（NHI）Medicloud系统。该研究揭示了导致不依从性的因素以及改善患者对慢性病药物依从性的影响。然而,小样本量限制了研究结果的普遍性。此外,该研究确定需要对更大和更多样化的样本进行进一步研究，以验证初步发现。
方法：这项研究调查了台湾中部地区接受三高药物治疗的个体和从连锁药店退回过期药物的个体。进行了包括C-TPMNS在内的结构化问卷，以及病史和HbA1c的其他数据，LDL,并从NHIMedicloud系统收集血压水平。采用多元有序logistic回归和Wald检验方法进行数据分析。设置解释截止点以确定药物不依从性。
结果：研究发现，25.8%的参与者不遵守处方药物。非粘附者的收缩压（SBP≥140mmHg）明显高于粘附者。不坚持也与低教育等因素有关，单一状态,独自生活,餐后葡萄糖浓度异常，和甘油三酯水平。C-TPMNS表现出良好的可靠性(Cronbach'sα=0.816)和有效性(ROC曲线下面积=0.72)。
结论：该研究强调了不同决定因素的药物依从性的复杂性，并强调了定制干预措施的重要性。研究结果强调了针对特定地区的研究的必要性，以全面解决药物依从性问题。特别是关注高血压药物的依从性，高脂血症,和糖尿病。该研究还确定了对更大的需求，更多样化的研究来验证和扩展初步发现，并强调药剂师干预和患者授权在管理慢性病和改善整体健康结局方面的重要性。
方法：这项研究调查了台湾中部地区接受三高药物治疗的个体和从连锁药店退回过期药物的个体。进行了包括C-TPMNS在内的结构化问卷，以及病史和HbA1c的其他数据，LDL,并从NHIMedicloud系统收集血压水平。采用多元有序logistic回归和Wald检验方法进行数据分析。设置解释截止点以确定药物不依从性。
结果：研究发现，25.8%的参与者不遵守处方药物。非粘附者的收缩压（SBP≥140mmHg）明显高于粘附者。不坚持也与低教育等因素有关，单一状态,独自生活,餐后葡萄糖浓度异常，和甘油三酯水平。C-TPMNS表现出良好的可靠性(Cronbach'sα=0.816)和有效性(ROC曲线下面积=0.72)。
结论：该研究强调了不同决定因素的药物依从性的复杂性，并强调了定制干预措施的重要性。研究结果强调了针对特定地区的研究的必要性，以全面解决药物依从性问题。特别是关注高血压药物的依从性，高脂血症,和糖尿病。该研究还确定了对更大的需求，更多样化的研究来验证和扩展初步发现，并强调药剂师干预和患者授权在管理慢性病和改善整体健康结局方面的重要性。
