| ObjectiveTo describe the medication compliance status of hypertension patients in community and explore the effect of nurse-led intervention on compliance and blood pressure control of the elderly community patients with high blood pressureand poor medication compliance in the mode of family doctor signing.MethodsThis study is an experimental study.First,a descriptive survey was conducted. Participants were recruited by convenient sampling from a community health service center of tianjin nankai district between May in 2013.and September in 2014. The self-report questionnaires were used to measure the medication compliance of 300 cases of patients with high blood pressure using the MMAS-8 and measuring participant’s blood pressure. According to the inclusion and exclusion criteria, a total of 80 patients with high blood pressure were included in this study. They were randomly divided into the experimental group(n=40) and the control group(n=40) by random number table. All of the participants were requested to finish the baseline questionnaire before the intervention. The control group received routine community intervention. On the basis of routine community intervention, the experimental group received signed family doctor service agreement with providing community nursing intervention measures. Compared effect of the experimental group’s medication compliance and blood pressure control with the control group after the intervention. In addition, observing the changes of two groups’ s patients with fasting plasma glucose(FBG),body mass index(BMI),total cholesterol(TC),triglyceride(TG). Using frequency and percentage to statistical describe the general and disease related data of patients.T-test, Chi-square test,multifactor regression analysis and repeated measure ANOVA were used to analyze the data with SPSS 16.0.Results1.The results of investigation and analysis.,the medication adherence of patients in community was poor.In the investigation of 300 cases of hypertension patients in community,the average adherence value according to the MMAS-8 was 5.8±1.85.The highest medication adherence accounted for 15.0%, medium medication adherence and poor medication adherence of patients accounted for 32.0% and 53.0% respectively. Adherent patients showed to be more prone to have blood pressure control than those who reached mean(6 to 8) or low values(<6) at the adherence score. MMAS-8 was showed a significant association with BP control.2.The results of intervention.2.1 The study found no significant difference in the demography, relevant clinical manifestation, the score of MMAS-8,blood pressure value, FBG,BMI, TC and TG(P>0.05).2.2 At 3 months after intervention,the average adherence score of MMAS-8 was 6.37±1.1 in experimental group and 5.48±1.9 in control group respectively. The average systolic pressure value was 132.95±14.77 in experimental group and 146.67±18.92 in control group respectively. The patients in the intervention group had a better improved of medication adherence and BP control after 3 months intervention(P<0.05).2.3 At 6 months after intervention,the average adherence score of MMAS-8 was 6.98±0.99 in experimental group and 5.76±1.78 in control group respectively. The average systolic pressure value was 128.60±12.8 in experimental group and 141.42±17.36 in control group respectively.The experimental group were significantly improved than the control group in blood pressure value,FBG,TC and TG.The differences were statistically significant(P<0.05).Conclusions1.Overall hypertensive’s medication adherence was poor.It was still a major health problem.2.Older age,low standard of culture and poorly control of blood pressure were the main factors that influence the medication compliance of hypertension patients in community.3.Adherent patients showed to be more prone to have blood pressure control than those whose medication compliance was poor.4.Nursing intervention obviously improved the elderly hypertensive’s medication adherence, so as to enhance the effect oftheir blood pressure control in the mode of family doctor service. In addition,the intervention also had obvious effect.on chronic disease management.This research gave play to the advantages of community nurses. It had a important meaning to refine and expand family doctor service,so as to provide important theoretical foundation. |
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