平鎮市老年人高膽固醇血症之就醫遵從行為及相關因素探討

Compliance to Medical Advice and Associated Factors among Elderly with Hypercholesterolemia in Ping-Jen City

張煥禎(Hung-Cheng Chang) ； 許詩典(Shin-Tien Shu) ； 謝泉發(Chuan-Fa Hsieh) ； 王美治(Mei-Chin Wang) ； 周騰達(Tang-Tat Chau) ； 蕭添木(Tien-Mu Hsiao) ； 陳右緯(Yu-Wei Chen)

《台灣老年醫學暨老年學雜誌》 5卷3期 (2010/08) Pp. 190-203

https://doi.org/10.29461/TGG.201008.0004

摘要

目的：老年人的血脂異常與心腦血管疾病間有直接的關聯，適當地血脂控制可減少疾病發生並降低後續臨床照護資源。在台灣之血脂異常個案尋求妥善治療或追蹤檢查之比例偏低，因此本研究嘗試以平鎮市高膽固醇血症之老年人口為對象，探討影響其就醫遵從行為及相關因素。
方法：本研究以參與壢新世代研究個案中，65歲以上且有高膽固醇血症之個案為對象，在取得其同意後，進行問卷調查及接受3個月的電話追蹤，以確認後續是否至醫療院所接受高膽固醇血症之追蹤。
結果：本研究共納入171人，平均年齡為72歲，於追蹤期間內至醫療院所治療或檢查比例為32.2%。在單變項統計分析中，與就診有顯著關聯之因子為不識字、個案過往有糖尿病史與心血管疾病史。上述三項因子於多變項邏輯式迴歸分析中控制其他有關變項後，仍有顯著關聯。
結論：本研究發現平鎮市老人於健康篩檢得知有高膽固醇血症後，尋求進一步檢查或治療之比例偏低。過往有糖尿病史、有心血管疾病史與不識字者，較積極至醫療院所尋求後續治療。

關鍵字

高膽固醇血症 ； 心腦血管疾病 ； 老人醫學

並列摘要

Objectives: The relationship of hypercholesterolemia and cardiovascular and cerebrovascular diseases has been reported in ample published papers. Appropriate management of hypercholesterolemia can reduce both the incidence and related healthcare expenditure. Previous studies, however, indicated poor control of hypercholesterolemia in the elderly. The aim of this study was to investigate the treatment-seeking behavior and the significant determinants of the elderly with hypercholesterolemia in Ping-Jen City.
Methods: Enrolled in the study of LI-shin Outreaching Neighborhood Screening (LIONS) between April 1, 2007 and March 31, 2008, subjects aged above 65 years old and diagnosed with hypercholesterolemia (defined as serum total cholesterol levels≧240 mg/dL) were followed up. Their demographic data and vascular risk factors were recorded upon their entries into this cohort study. After hypercholesterolemia through blood chemistry tests was confirmed, a three-month observation was performed to determine the patients' compliance with medical advice.
Results: A total of 181 patients were recruited in this study, and 171 (94.5%) with a mean age of 72.1±5.9 years old completed the survey. Among them, 32.2% visited the outpatient clinics and hospitals during the follow-up period. The significant factors influencing compliance were illiteracy (adjusted Odds Ratio (aOR)=3.02, 95% confident intervals (CI)=1.26-7.23), history of diabetes mellitus (aOR=4.54, 95% CI=1.56-13.23), and cardiovascular disease (aOR=3.71, 95% CI=1.10-12.57).
Conclusion: Less than one third of the target subjects who were diagnosed of hypercholesterolemia by the health examination reported treatment-seeking behavior afterwards. Patients with illiteracy and history of diabetes mellitus or cardiovascular disease were more likely to comply with medical advice.

並列關鍵字

hypercholesterolemia ； cardiovascular and cerebrovascular diseases ； geriatric medicine