目的:确定药物处方模式的影响,门诊药品价格,以及埃塞俄比亚南部部分医院对基于证据的国际血压控制指南的遵守程度。
方法:进行以医院为基础的横断面研究。采用SPSS21.0版进行数据录入和分析。
结果:参与者的平均年龄为55.87±11.02岁。根据国际高血压协会(ISH)指南2020,BP控制率为17.5%。在大约三分之二的患者中,270例(66.5%)采用联合治疗。高血压药物的平均年费用为11.39±3.98美元(美元)。只有91例(22.4%)患者的治疗是负担得起的。处方者对循证指南的依从性有很大差异。体重指数(BMI)为18-24.9kg/m2,调整后比值比(AOR)=3.63(95%置信区间(C.I),1.169-11.251,p=0.026),身体活动,AOR=12.69(95%C.I,1.424-113.17,p=0.023),没有合并症的存在,AOR=12.82(95%C.I,4.128-39.816,p=0.000),采取负担得起的降压方案,AOR=3.493(95%C.I,1.4242-9.826,p=0.018),血压控制呈正相关。
结论:血压控制水平,高血压和相关合并症管理药物的可负担性,处方者对循证指南的依从性不足.因此,解决与良好BP控制相关的因素,包括相关利益相关者的负担能力和临床医生对循证指南的依从性,可以改善BP控制并减少相关并发症.
OBJECTIVE: To determine the impact of drug prescribing pattern, outpatient drug price of medicines, and level of adherence to evidence-based international
guidelines on blood pressure (BP) control at selected hospitals in Southern Ethiopia.
METHODS: Hospital-based cross-sectional study was conducted. The data entry and analysis were done by using SPSS version 21.0.
RESULTS: A mean age of participants was 55.87 ± 11.02 years. The rate of BP control was 17.5% based on International Society of Hypertension (ISH)
guidelines 2020. In about two-thirds of patients, 270 (66.5%) were taking combination therapy. Mean annual cost of drugs for hypertension was 11.39 ± 3.98 US dollar (USD). Treatment was affordable for only 91 (22.4%) of patients. There was considerable variation on prescriber\'s adherence to evidence-based
guidelines. Body mass index (BMI) of 18-24.9 kg/m2, adjusted odds ratio (AOR) = 3.63 (95% confidence interval (C.I), 1.169-11.251, p = 0.026), physically activity, AOR = 12.69 (95% C.I, 1.424-113.17, p = 0.023), presence of no comorbidity, AOR = 12.82 (95% C.I, 4.128-39.816, p = 0.000), and taking affordable antihypertensive regimen, AOR = 3.493 (95% C.I, 1.4242-9.826, p = 0.018), were positively associated BP control.
CONCLUSIONS: The level of BP control, affordability of drugs for the management of hypertension and related comorbidities, and the prescriber\'s adherence to evidence-based
guidelines were inadequate. Therefore, addressing factors associated with good BP control including affordability and clinician adherence to evidence-based
guidelines by responsible stakeholders could improve BP control and reduce associated complications.