■虽然在中国,药物依从性欠佳仍然是高血压和糖尿病管理的障碍,很少有研究同时调查与不同维度药物依从性相关的因素.
■要系统地检查相关患者,家庭,和社区因素与中国高血压和/或2型糖尿病患者的服药依从性欠佳。
■该研究对2019年来自中国东南三个城市的622名45岁以上患有高血压和/或2型糖尿病的成年人进行了随机抽样。训练有素的面试官使用MoriskyGreenLevine药物依从性量表,慢性病管理自我效能感量表(SEMCD),家庭适应性,伙伴关系,增长,感情,和决心(APGAR)量表评估药物依从性,自我效能感,和家庭功能,分别。参与者还报告了他们对社区卫生服务的满意度(数量,质量,负担能力,和总体接受度)。该研究使用多变量逻辑回归来评估患者之间的关联,家庭,和社区因素与药物依从性欠佳。
■在参与者中,42.9%报告药物依从性欠佳。在多变量逻辑回归模型中,男性参与者(比值比[OR]=0.55,p=0.001)的服药依从性高于女性.自我效能得分低于或等于样本平均值与较低的依从性显着相关(OR=1.44,p=0.039)。对社区卫生服务和药物的可负担性不满意的参与者的依从性(OR=2.18,p=0.028)低于中立或满意的参与者。家庭功能与药物依从性之间没有显着关联。
■性,自我效能感,社区卫生服务的可负担性是影响服药依从性的重要因素。建议医疗保健专业人员在促进药物依从性时考虑多种因素并利用社区卫生中心的服务和资源。
UNASSIGNED: While suboptimal medication adherence remains an obstacle to the management of hypertension and diabetes in China, few studies have investigated associated factors with medication adherence on different dimensions simultaneously.
UNASSIGNED: To systematically examine associated patient, family, and community factors with suboptimal medication adherence among people with hypertension and/or type 2 diabetes in China.
UNASSIGNED: The study stratified a random sample of 622 adults aged 45 years or older with hypertension and/or type 2 diabetes from three southeast cities in China in 2019. Trained interviewers used the Morisky Green Levine Medication Adherence Scale, Self-Efficacy to Manage Chronic Disease (SEMCD) Scale, and the Family Adaptability, Partnership, Growth, Affection, and Resolve (APGAR) Scale to assess medication adherence, self-efficacy, and family function, respectively. Participants also reported their perceived satisfaction with community health services (quantity, quality, affordability, and overall acceptance). The study used the multivariable logistic regression to assess the association of patient, family, and community factors with suboptimal medication adherence.
UNASSIGNED: Among the participants, 42.9% reported suboptimal medication adherence. In the multivariable logistic regression model, male participants (odds ratio [OR] = 0.55, p = 0.001) had higher medication adherence compared to females. Having a self-efficacy score that was lower than or equal to the sample mean was significantly associated with lower adherence (OR = 1.44, p = 0.039). Participants unsatisfied with the affordability of community health services and medicine had lower adherence (OR = 2.18, p = 0.028) than those neutral or satisfied. There were no significant associations between family function and medication adherence.
UNASSIGNED: Sex, self-efficacy, and perceived affordability of community health services were important factors associated with medication adherence. Healthcare professionals are recommended to consider multiple factors and leverage services and resources in community health centers when promoting medication adherence.