The Rural Elderly Hypertension Patients Mendication Adherence Factors And The Intervention Model Restruction

Objective:By investigating the rural elderly hypertensive patinents medication adherence.Based on the theory "health ecological model",to study the factors of the medication compliance. And in order to improve the elderly hypertension patients medication compliance that occupy the home,adjust measures to local conditions and provide a scientific basis for intervention model construction.Methods:Adopt multi-stage cluster random sampling method,extracting 354 hypertension patients which insists in the health management of hypertension in the brackets.With the method of questionnaire survey,centralizing the patients or talking alone to finish the questionnaires.Types of questionnaire including the general demographic information, Morisky Medication Adherence Scale-8 (MMAS-8), Therapeutic adherence scale for hypertensive patients(TASHP), Antihypertensive Therapy Related Attitudes and Beliefs Scale(ATRABS).Based on the theory "health ecological model",to analyze the factors.All data registered on the SPSS 19.0 statistical package,general data using the descriptive statistical analysis,relative factors employing the single factors analysis,count data using the spearman rank correlation analysis,and unconditioned multivariate logistic regression analysis to analyze the medication adherence levels.Results:1.The prevalence of the three towns is different(P<0.05),the Shuiyuan county is 40.78%,Xianan county is 36.07%,Daan county is 13.25%.2.The data show that,there are 226 patients who are medication adherence poor(63.8%),86 patients who are medium(24.3%),42 patients is good(11.9%); which more,205 cases therapy adherence is low(57.9%),164 patients attitude and belief is bad.3.The age,education level,residence place,disease year,blood pressure level and the low-coming are relative with medication adherence (P< 0.05);the behavior of medical treatment,bad habit,daily life management,tobacco and alcohol addition,beside,the attitude and beliefs,lifestyle continued treatment concerns,insis on attitudes and beliefs are positively related to the medication adherence(P<0.05).By the theory classical,the upper level fators are education level,resident,low-coming,the middle level fators are the behavior of medical treatment,bad habit,daily life management,tobacco and alcohol addition,and beliefs,lifestyle continued treatment concerns,insis on attitudes and beliefs,the lower level are the blood pressure level,age and the disease year.4.In the poor patients,the iliteracy/semiliterate(OR=6.522) and the adverse drug behavior(OR=13.834) are the risk factor;living in the villages(OR=0.563),daily life management behavior (OR=0.370),treatment attitude and beliefs(OR=0.535) are protective factors.In the moderate patients,70-79 years old (OR=0.317), resident in thevillage(OR=0.186), daily life management behavior (OR=0.776),attitude and beliefs (OR=0.631), treatment adherence attitudes and beliefs (OR=0.809) are the risk factor.Conclusions:1.The management of the public health systems is more perfect,the prevalence rate is lower.2.The rural elderly hypertensive patients medication adherence is low,which is lower than other areas.In the factors,the upper level factors such as the education,resident and low-coming are the key effect to the lower;the behaviors and the beliefs are important to the lower level;which more,the age,blood pressure level and disease year as the downstream factors is relatively minor,mainly affected by the above factors.