- 期刊
以簡化藥物治療方式改善門診高血壓病患服藥遵從成效探討：系統性文獻回顧
Simplified Medication in Improving Adherence among Ambulatory Patients with Hypertension: A Systematic Review
摘要
血壓無法控制在理想範圍主要原因之一為服藥遵從不佳。本研究目的為回顧簡化藥物治療對於改善高血壓病患服藥遵從成效。以系統性回顧簡化藥物治療改善門診高血壓病患服藥遵從文獻，資料庫搜尋至2011年4月，搜尋CENTRAL、MEDLINE、EMBASE、CINAHL、臺灣期刊論文索引系統、中國期刊全文資料庫及中文思博網。研究篩選出十六篇隨機控制實驗文獻，文獻研究年代介於1981至2009年，研究地區為歐洲、美國、加拿大，研究人數介於23至7,274人，介入時間為三週至八個月。結果發現簡化服藥品項與顆數介入研究有三篇文獻，只有一篇文獻對於改善服藥遵從呈顯著差異，兩組服藥遵從相差7.8%。簡化服藥頻率介入研究有十三篇文獻，有九篇文獻對於改善服藥遵從呈顯著差異，兩組服藥遵從相差1 ~ 13%。文獻回顧發現簡化服藥品項與顆數，對於改善服藥遵從並沒有顯著介入成效，而簡化服藥頻率對於改善服藥遵從卻有顯著介入成效。因此改善高血壓病患服藥遵從介入方式，並不能只進行簡化藥物治療，應進行混合介入方式，才能有效持續改善病患服藥遵從與血壓控制。
並列摘要
Poor adherence to antihypertensive medications is a major reason for inadequate control of hypertension. The purpose of this communication is to review the effectiveness of simple medication in improving adherence among hypertensive patients. The information is obtained mainly from the following sources: CENTRAL, MEDLINE, EMBASE, CINAHL, Index to Taiwan Periodical Literature System, China Journal Full-text Database and Chinese Electronic Periodical Services for all-language publications in April 2011, all studies included sixteen randomized controlled trials in 1981 to 2009, and 23 to 7,274 hypertensive outpatients in Europe, United States of America and Canada with follow-up duration of 3 weeks to 8 months. The results indicate that significant difference in adherence with regard to simplifying medication types and pill count occurs in 1 of 3 studies, with a relative increase in adherence by 7.8%. Significant difference also exists by simplifying dosage frequency in 9 of 13 studies, with a relative increase in adherence by 1 to 13%. The conclusion is that simplification of dosage frequency significantly increases adherence. On the other hand, no significant effect on adherence is found by simplifying medication types and pill count. Although simplified medication alone appears to be effective in improving adherence in hypertensive patients, complex interventions should be included to achieve continuation in improving adherence.
被引用紀錄
延伸閱讀
- 楊玨璿（2009）。某醫學中心門診高血壓病人服藥遵守行為之探討--自我效能及行動線索之影響〔碩士論文，國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342/NTU.2009.02253
- 彭莉琴（2000）。某醫學中心中風高血壓病人遵醫囑服藥行為階段及相關因素之探討〔碩士論文，國立臺灣師範大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0021-1804200716555999
- 蘇秋萍、楊琇玲、林盈秀、洪敏瑛、黃月嬌（2017）。降低某醫院靜脈化療藥品給藥異常發生率之改善專案。腫瘤護理雜誌，17(2)，79-92。https://doi.org/10.3966/168395442017121702007
- 洪芳玲（2003）。個案管理模式於門診高血壓病患照護成效之探討〔碩士論文，臺北醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0007-1704200714522876
- Theodorou, M., Stafylas, P., Kourlaba, G., Kaitelidou, D., Maniadakis, N., & Papademetriou, V. (2012). Physicians' Perceptions and Adherence to Guidelines for the Management of Hypertension: A National, Multicentre, Prospective Study. International Journal of Hypertension, 2012(), 392-402. https://doi.org/10.1155/2012/503821