健康教育对缺血性脑卒中患者二级预防他汀类药物依从性的观察

目的:评估健康教育对缺血性脑卒中患者在二级预防中他汀类药物依从性的影响。方法:将2012年1月至2012年4月,于北京安贞医院普内科住院治疗的缺血性脑卒中患者124例,应用临床随机对照研究,分为干预组(60例)和对照组(64例),对干预组进行规范的健康教育,对照组仅给予一般的科普宣教,观察两组患者随访3个月、6个月及1年时的他汀类药物使用情况。结果:完成随访117例,干预组57例,对照组60例,健康教育组患者他汀类药物使用率在3个月、6个月及1年时明显高于对照组(分别为76.3%vs.49.2%,P=0.004;70.7%vs.43.5%,P=0.003;64.9%vs.33.3%,P=0.001)。健康教育能明显提高无高血压、糖尿病、冠心病、脑卒中病史,非医保患者血管共病个数较少者他汀类药物的使用率。结论:健康教育能明显提高缺血性脑卒中患者他汀类药物的依从性,且对无血管性危险因素,血管共病个数较少的患者影响显著。健康教育对非医保患者长期坚持他汀类药物的使用起到显著促进作用。

The effect of health education on statins adherence in secondary prevention of cerebral ischemia

Objective：In order to evaluate the effect of health education on statins adherence in Secondary Prevention of cerebral ischemia. Methods： 124 cerebral ischemic patients admitted in Department of internal medicine of Beijing Anzhen Hospital between Jan 2012 and Apr 2012 were randomly divided into two groups,intervention group was given comprehensive health education while control group was given general education. Assess their statins adherence in 3,6,12 month after discharged. Results： 117 patients completed the follow-up,57 in intervention group,60 in control group. Patients in intervention group had better statins adherence than control group in 3,6,12 month after discharged（ 76. 3% vs. 50. 8%,P = 0. 004; 70. 7% vs. 43. 5%,P = 0. 003; 64. 9% vs. 33. 3%,P = 0. 001）. Health education can significantly improve statins adherence in patients with non-Medicare、no vascular risk factor,and less vascular comorbidities with no history of hypertension、diabetes、coronary heart disease、and stroke. Conclusion： Health education can significantly improve statins adherence in cerebral ischemic patients,especially in patients with no vascular risk factor or less vascular comorbidities. Health education played a key role in long-term sttins adherence in non-medicare patients.