| Objective:To investigate the compliance of statins in population with cardiovascular risks at the grass-roots unit,and analyzing the influencing factors and causes of the poor compliance,so as to provide evidence for improving compliance of patients and further reduce the risks of cardiovascular disease at the grass-roots unit.Methods : A cross-sectional survey was about 402 patients with cardiovascular disease risks who had been signed by general practitioners in a community of Tianjin.The basic information and disease information of the patients were extracted from the electronic health records,and the medical information were extracted from self-made questionnaire of the residents.Patients who needed statins and prescribed were screened.According to the voluntary principle of patients,the Chinese revised version of the compliance Morisky scale was used to investigate the compliance of patients,and the influencing factors were analyzed.At the same time,the reasons for the poor compliance of the patients were investigated.Using Epi Data3.1 software to set up a database for data entry.And SPSS22.0 software was used for statistical analysis.Results:1.According to the guidelines for the prevention and control of dyslipidemia in Chinese adults(2016 Revised Edition),which stipulated the standard of risk stratification and initiation of statin therapy for patients with ASCVD in the next 10 years.Of the 402 subjects,186 people who needed to take statins were selected.64%of the patients were prescribed(119/186),of whom 7.6%(9/119)did not take the drug,and 92.4% took the drug(110/119).2.According to the risk assessment of ASCVD in the next 10 years,among the 110 patients who were given prescription and took the medicine,there were 18 cases of "middle risk group" and 92 cases of "high risk group".The compliance was "good" accounted for 30.0%(33/110),the compliance was "poor" accounted for 70.0%(77/110).In the middle risk group,the compliance "good" accounted for 27.8%(5/18),and the compliance "poor" accounted for 72.2%(13/18);in the high risk group,the compliance "good" accounted for 30.4%(28/92),and the compliance "poor" accounted for 69.6%(64/92).3.The outcomes of single factor analysis suggested: education level,occupation,and drug types at the same time had statistically significant difference(P<0.05).Multivariate logistic regression analysis was used to analyze the characteristics of statistical significance in single factor analysis.The results showed that: higher education level and fewer total drug users had better compliance,and the difference was statistically significant compared with the occupation(P<0.05).4.The reasons for the subjects investigated who did not take medicine sujested:fearing of adverse reactions in 6 cases((66.7%)),thinking having no symptoms and did not need to have medication in 3 cases(33.3%).The reasons leading to poor medication adherence were investigated: thinking having no symptoms and did not need to have medication in 31 cases(40.2%),thinking the medications were invalid in 28 cases(36.4%),fearing of adverse reactions in 16 cases(20.8%),having economic pressure in 2 cases(2.6%).The results suggested that the most important reason for the poor compliance of the patients was patients thought they had no symptoms and did not need to take the medicine.Conclusions:There is still a big gap between the use of statins and the recommendations of the revised guide of 2016,which were in middle and high risk patients with cardiovascular disease contracted by primary general practitioner,and the percentage of patients with poor compliance with statins was higher.The level of education and the types of medication are independent risk factors for medication adherence.The main reason for poor medication compliance is the lack of awareness of cardiovascular disease prevention.Therefore,strengthening the interaction of doctors and patients,improving patients’ understanding of the prevention of cardiovascular disease,and strengthening the promotion and standardized application of statins are the important contents of the primary prevention of primary cardiovascular disease in grass-roots unit. |
