The Investigation And Research On The Medication Compliance In Community Patients With Hypertension

ObjectivesThrough the survey of medication compliance in hypertension patients in community to analyze the effect of different medication compliance on blood pressure and the risk factors of medication compliance in patients with hypertension.This study provide tools for clinicians to screen patients with poor medication compliance and provide guidance for clinicians intervention the medication compliance behavior systemly in patients with hypertension.MethodsWe recruited 268 patients with primary hypertension.We conducted the study via a face-to-face interview,using Morisky medication compliance scale-8(MMAS-8),Risk factor questionnaire,Health belief model(HBM)questionnaire for appropriate medication use scale.The datawascollectedfromthewellpreparedquestionnairewhich wasfilled outcarefully by the chosen patients.The statistical analysis was conducted with SPSS software version20.0.Results1,The 268 eligible participants showed low,medium and high compliance,66(24.6%),60(22.4%)and 142(53.0%)respectively.2,Evaluation by Morisky scale,the medication compliance had significant influence on the mean SBP and mean DBP of patients with hypertension.The mean SBP was147.9±18.1 mmHg,138.1±13.5 mmHg,136.1±14.8 mmHg(F = 13.297,p < 0.001)for patients with low,medium and high compliance,the mean DBP was 89.4±10.2 mmHg,80.0±9.2 mmHg,81.5±9.2 mm Hg(F = 19.874,p < 0.001)for patients with low,medium and high compliance.3,A single factor analysis was conducted on the risk factors of medication compliance,it showed that patients' antihypertensive compliance was associated with the factors of age(p = 0.029),duration of hypertension(p = 0.020),duration of drug use(p =0.007),family history(p < 0.001),combination of anti-platelet aggregation drugs(p =0.001),side effects(p = 0.010),medical cost burden(p < 0.001),guidance from medical professionals(p < 0.001),guidance from family members(p = 0.002),hypertensive knowledge(p < 0.001).In the logistic analysis,the factors of family history(p = 0.008),combination of antiplatelet agents(p = 0.001),medical cost burden(p = 0.001),guidance from medical professionals(p = 0.026)were identified to independently affect medication compliance among hypertensive patients.4,In the one-way ANOVA,all 6 HBM constructs were significantly associated with medication compliance.The HBM explained 40.4% of the variance in antihypertensive medication compliance with an overall prediction accuracy was 79.5%.After adjusting for risk factors,the HBM explained 44.4% of the variance in antihypertensive medication compliance with an overall prediction accuracy of 83.6%.In the logistic analysis,higher levels of perceived susceptibility(p = 0.044,OR=1.28),perceived barriers(p<0.001,OR=0.56),and self-efficacy(p = 0.002)and a lower level of perceived barriers(p < 0.001)were significantly associated with better antihypertensive medication compliance.ConclusionThe study shows that there are 47% of the hypertension patients with lower medication compliance.Medication compliance is high,compliance rate of blood pressure is higher.The medication compliance of patients were influence by family history of hypertension,whether the merger of antiplatelet drugs and pressure of medical expenses and medical personnel to guide medication and other risk factors.The HBM can accurately predict the compliance of hypertensive patients,and can be used as a effective tool for clinicians to screen medication compliance.In patients with high medication adherence,the susceptibility and self-efficacy levels are higher in the questionnaire of HBM and the lower of sexual awareness.So we can see that these two questionnaires are consistent with the evaluation results of the medication compliance of the patients.