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目的了解社区老年高血压患者药物治疗依从性并探讨其影响因素。方法对362例天津市河西区尖山街社区服务中心老年高血压患者采用门诊及电话随访进行问卷调查,采用MOR1SKY评价高血压药物治疗依从性。结果服药依从性佳者占67.1%,不佳占32.9%。依从性不佳者中,32.77%患者认为服药后血压恢复正常就可以停药,23.53%认为无症状没必要服药,18.49%因用药复杂忘了服药。单因素分析结果显示,文化程度、服药种类、服药次数、并发症、会自测血压及规律自测血压对高血压药物治疗依从性有统计学意义(P<0.05)。非条件Logistic多因素回归分析显示,规律自测血压、服药种类及服药次数是影响高血压药物治疗依从性的独立因素(分别为OR=1.962,95%CI:1.137～3.383,OR=0.275,95%CI:0.144～0.525,OR=0.580,95%CI:0.414～0.812)。结论该社区老年高血压患者药物治疗依从性相对较高,但仍需普及并落实高血压防治指南,选择最佳治疗方案,大力推广家庭自测血压等。
Objective To understand the compliance of drug therapy in elderly hypertensive patients in community and explore the influencing factors. Methods 362 elderly patients with hypertension in Jianshanjie Community Service Center, Hexi District, Tianjin City were surveyed by telephone and outpatient service. MOR1SKY was used to evaluate compliance of hypertensive drugs. Results good compliance medication accounted for 67.1%, poor accounted for 32.9%. Among those with poor compliance, 32.77% thought they could stop taking their blood pressure after taking medicine, 23.53% thought it was no need to take medicine and 18.49% did not take medicine because of complicated medication. The results of univariate analysis showed that the degree of education, the type of medication, the frequency of taking medication, the complication, the self-measured blood pressure and the regular self-test blood pressure were statistically significant (P <0.05). Logistic multivariate regression analysis showed that the self-rated blood pressure, the type of medication and the number of taking medication were the independent factors influencing the compliance of hypertensive drugs (OR = 1.962, 95% CI: 1.137-3.383, OR = 0.275, 95 % CI: 0.144-0.525, OR = 0.580, 95% CI: 0.414-0.812). Conclusion The community of elderly hypertensive patients with relatively high adherence to drug treatment, but still need to popularize and implement guidelines for prevention and treatment of hypertension, choose the best treatment options, and vigorously promote family self-test blood pressure.