Situation Of Blood Pressure Control And Medication Adherence In Rural Elderly Patient With Hypertension In Different Seasons

Objective:To explore the status quo of blood pressure control and Medication Adherence in rural elderly patients with hypertension in different seasons,and analyze the factors influencing blood pressure.Methods:This was a cross-sectional study by convenient sampling.The general data questionnaire and Morisky medication adherence scale were used to collect the data.From December 2016 to January 2017 and June to July 2017,538 rural elderly participants with hypertension in Changshu(285 cases in Meili and 253 in Shajiabang)were investigated.The status quo of blood pressure and medication adherence and the risk factors to affect blood pressure control were explored in rural elderly patients with hypertension in different seasons.Results:1.In cases of 538 elderly patients with hypertension in rural areas,the cases with good control of blood pressure in winter and summer were 350(65.1%)and 441(82%),respectively.There was a significant difference in the rates of blood pressure control between winter and summer(P < 0.01).2.In the winter and the summer,the scores of Morisky medication adherence in this group were 6.14±1.89 and 5.72±1.88,respectively,and there was a significant difference in medication compliance between two seasons(P < 0.01).The each item of Morisky medication adherence were further analyzed: the differences of scores in item 1 "did yousometimes forget to take the medicine?",item 2 "did you forget to take the medicine for one or more days in the past two weeks?" and item 5 "did you take the medicine yesterday?" were significant(P < 0.01),which the scores of these three items in winter were significantly higher than those in summer.3.Spearman correlation analysis showed: in the winter,the factors related to the blood pressure control in this study included age(r=-0.114,p=0.008),the duration of hypertension(r=-0.138,p=0.001),the numbers of other chronic diseases(r=-0.145,p=0.001),sleep problem(r=-0.119,p=0.006),the number of hypertension drugs patients took(r=-0.124,p=0.004),the number of drugs patients took in all the day(r=-0.118,p=0.006).while the factors related to blood pressure control in the summer was the frequency of blood pressure monitoring(r=-0.089,p=0.040).4.The results of unconditioned multivariate Logistic regression showed: in the winter,the factors associated with blood pressure control in rural elderly patients with hypertension included age(OR=0.967,95%CI=0.940-0.995;P=0.019),BMI(OR=0.904,95%CI=0.855-0.956;P<0.001)and item 1 "did you sometimes forget to take the medicine?"(OR=1.951,95%CI=1.119-3.401,P=0.018)of Morisky medication adherence scale.While in the summer,the factors associated with blood pressure control included the frequency of blood pressure monitoring(OR=0.672,95%CI=0.470-0.962;P=0.030)and item 2 " did you forget to take the medicine for one or more days in the past two weeks?"(OR=0.399,95%CI=0.181-0.881,P=0.023),item 4."did you sometimes forget to carry drugs when you are out?"(OR=1.838,95%CI=1.024-3.299;P=0.042)of Morisky medication adherence scale.Conclusion:The blood pressure control rate of rural elderly patients with hypertension in winter was lower than that in summer,while the medication adherence was the opposite.The influencing factors of blood pressure control in rural elderly patients with hypertension in different seasons were different.The nursing staff should be based on different factorsaffecting blood pressure on patients to take corresponding measures to help patients control blood pressure more effectively.