Associated Factors Towards Medication Compliance Among Patients Who Have Hypertension And Diabetes In Yunnan Province

Backgrounds:The multimorbidity with hypertension and diabetes is not just a single patients with hypertension, nor individual diabetes patients, more than the simple superposition of directly. In our country some provinces have carried out extensive research on hypertension and diabetes, but lack of studies on multimorbidity with hypertension and diabetes, and Yunnan province also lack of studies in this area. The multimorbidity with hypertension and diabetes and the single with hypertension and diabetes have difference was particularly notable on demography, lifestyle and medication compliance.Objectives:This study selected nanhua longchuan township health center of Yunnan for a case study. This research aims to explore the difference and analyze the influence factor of medication compliance in multimorbidity with hypertension and diabetes and in single with hypertension and diabetes and propose solutions in order to implement interventions in the future.Methods:This study will carry out the research by implementing a quantitative survey using existed data collection, one-on-one in-depth interviews, group interviews, non-participant observation, as well as other quantitative and qualitative research methods. In nanhua longchuan township health center of Yunnan, the survey was given to the relevant indicators of 1912 the multimorbidity with hypertension and diabetes and the single with hypertension and diabetes from chronic diseases archives management system in 2015, and 35 relevant key informators. All the data were Double-entered by EpiData and analyzed by SPSS statistical software package.Results:(1) Basic condition:Women accounted for 63.3% of 1912 patients, and women respectively accounted for 68.3%,63.0% and 68.3% in the multimorbidity with hypertension and diabetes, the hypertension and the diabetes(P=0.022). The mean age of 1912 patients were 65.5 years, which consisted of 18.1% multimorbidity with hypertension and diabetes,71.8% hypertension and 10.1% diabetes, and the average age was 67.5,65.4 and 62.1 years old respectively (P< 0.001).97.0% patients only attained junior school education, the multimorbidity with hypertension and diabetes, hypertension, diabetes accounted for 96.0%,97.4% and 97.4% respectively (P=0.005).83.6% patients pay medical bills with new rural cooperative medical system (NCMS), the multimorbidity with hypertension and diabetes, hypertension, diabetes accounted for 74.1%,85.8% and 74.1% respectively (P<0.001).73.7% patients taking medicine on time, the multimorbidity with hypertension and diabetes, hypertension, diabetes accounted for 66.0%,75.9% and 75.9% respectively (P=0.001). 347 multimorbidities with hypertension and diabetes were first diagnosed hypertension (48.7%), first diagnosed diabetes (14.4%), and hypertension and diabetes diagnosis accounted for 36.9%.(2) Univariate analysis of medication compliance:The rate of taking medicine on time for 1912 patients, women (75.3%) were higher than men (71.0%) (P=0.041), the over 60 age group was highest (75.3%) in the age group, the han nationality group (75.2%) was higher than other ethnic groups (72.7%) (P<0.001), illiteracy and semiliterate group was lowest (61.7%) (P<0.05), married group (74.3%) was higher than single group (70.8%), pay medical bills with NCMS group (70.1%) was lower (P<0.001), occasional exercise group and don’t exercise group were same (P<0.001), smoking group (68.0%) was inferior to non-smoking group (74.6), drinking group (65.9%) was inferior to non-drinking group (74.0%), psychological adjustment good group (87.6%) and according to the medical behavior good group (87.9%) were higher than in general group (P<0.001). The rate of taking medicine on time for the multimorbidity with hypertension and diabetes, women (69.2%) were higher than men (59.1%), rising with the age growth, the han nationality group (67.7%) was higher than other ethnic groups (47.1%), increasing with culture degree increased, farmer group (64.7%) was lower than other practitioners group (70.0%), married group (66.9%) was higher than single group (59.6%), pay medical bills with NCMS group (56.4%) was lower (P<0.001), increasing with prolonged hypertension and diabetes diagnosis, daily exercise group (92.9%) was highest (P<0.05), smoking group (61.3%) was inferior to non-smoking group (66.5), drinking group (42.1%) was inferior to non-drinking group (67.3%), decreasing with perturbation exacerbated by the use of salt, and decreasing with increasing daily food intake (P<0.05), psychological adjustment good group (76.8%) and according to the medical behavior good group 77.9%) were higher than in general group (P< 0.001).(3) Multivariate logistic regressions of medication compliance:For 1912 patients the disease states of the multimorbidity with hypertension and diabetes can decrease the rate of taking medicine on time; women, high degree of culture, pay medical bills with the basic medical insurance for urban workers and residents, daily exercise, psychological adjustment and according to the medical behavior good can improve the rate of taking medicine on time. For the multimorbidity with hypertension and diabetes daily food intake can decrease the rate of taking medicine on time; pay medical bills with the basic medical insurance for urban workers and residents, long diagnosed diabetes, insist on exercising every day, according to the medical good behavior can improve the rate of taking medicine on time.Conclusions:This study found that for the multimorbidity with hypertension and diabetes the influence factors of medication compliance were the medical expenses payment, diagnosed diabetes, frequency of exercise, daily food intake and according to the medical behavior. Disease status, gender, educational level, medical expenses payment, frequency of exercise, psychological adjustment and as directed by the medical behavior was nanhua longchuan township health center of hypertension and diabetes patients were the main factors of medication compliance, it is necessary to strengthen health education for the multimorbidity with hypertension and diabetes, male, low level of education, pay medical bills with NCMS, often do not exercise, poor psychological adjustment and as directed by the medical behavior of the crowd as a chronic disease management the focus of the crowd.Suggestions:(1) Developing health management service specification for the multimorbidity with hypertension and diabetes;(2) Paying more attention to the multimorbidity with hypertension and diabetes;(3) Setting up health management system for the multimorbidity with hypertension and diabetes;(4) Strengthening the health education for the multimorbidity with hypertension and diabetes.