贵阳市高血压患者药物依从性及其影响因素研究

目的：通过分析贵阳市高血压患者药物依从性对血压控制及费用负担影响，评价贵阳市基层卫生服务体系建设和公共卫生政策实施效果。方法：应用分层随机抽样方法，对贵阳市6个社区卫生服务中心的805名高血压患者进行结构式问卷调查。结果：社区高血压患者药物依从性好的比例占55．3％；55—64岁年龄组患者药物依从性不佳的概率是55岁及以下年龄组的0．49倍，高血压2级患者药物依从性不佳的概率是高血压1级的1．42倍；医疗支出占家庭收入比例超过20％的患者，其药物依从性不佳的概率比医疗支出占家庭收入比例小于10％的患者高1．21倍；药物依从性差的主要影响因素是年龄、高血压等级及经济负担。结论：社区应加强55岁以下年龄组高血压患者及65岁以上年龄组高血压患者管理，注重对高血压2级患者的服药指导和监督，以及加强对高血压患者健康教育的工作力度，探索以社区为基础的慢性病管理模式，有效提高高血压患者的药物依从性。

Study on the Compliance of Patients with Antihypertensive Therapy and Its Influencing Factors in Guiyang

Objective ： To analyze the compliance of patients with antihypertensive therapy and its influencing factors, to reflect development and effectiveness of basic health insurance system and public health care policy. Methods：805 hypertension patients were surveyed with structured questionnaire through stratified random sampling in 6 community health care centers in Guiyang City. Results ：55.3% hypertension patients in community were compliance with hypertension medication in Guiyang City. Patient with 55 - 64 years old were 0.49times less likely to be poor compliance with hypertension medication than patients with younger than 55 years old. Patients with hypertension stage 2 werel. 42 times more likely to be poor compliance with hypertension medication than patients with hypertension stage 1. And patients with more than 20% expense of household annual income were 1.21 times more likely to be poor compliance with hypertension medication than patients with less than 10% expend of household annual income, and the main risk factors are age, hypertension stage and burden of disease. Conclusion： Government should strengthen health management of patients with younger than 55 and older than 75 years old and pay attention to patients with hypertension stage 2 in medication guidance and supervision. Health education and management pattern should be explored to increase compliance of patients with antihypertensive therapy.