Adherence to Antihypertensive Medications among the Elderly: A Community-based Survey in Tainan City, Southern Taiwan

台南市老年高血壓患者服藥遵醫囑情形及其相關因素之探討

林玉珮(Yu-Pei Lin) ； 黃盈翔(Ying-Hsiang Huang) ； 楊宜青(Yi-Ching Yang) ； 吳晉祥(Jin-Shang Wu) ； 張智仁(Chih-Jen Chang) ； 盧豐華(Feng-Hwa Lu)

《台灣老年醫學雜誌》 2卷3期 (2007/02) Pp. 176-189

https://doi.org/10.29462/TGG.200702.0002

摘要

高血壓爲心血管疾病的獨立危險因子，且其盛行率在許多國家的老年人已超過60%。理想血壓控制率僅約30%，未能遵照醫囑服藥是重要因素之一。爲探究台南市老年高血壓患者服藥遵醫囑情形及其影響因素，故從事本社區性的調查。
以橫斷面研究設計，採分層集束抽樣法，共完成876位（完成率70.2%）台南市65歲及以上老年人的資料收集。其中已知有高血壓且正接受醫師處方藥物治療者有144位，若能遵照醫囑使用80%及以上之藥物者，將被視爲良好服藥遵醫囑性者。
台南市老年人良好服藥遵醫囑率爲57.6%。在單變項分析中發現，遵醫囑性好組有顯著較低的每日降壓藥使用頻次，較高比率的個案在近一年內做過健康檢查、認爲吃藥對疾病有或非常有幫忙者以及半年內未曾因吃藥而發生副作用者。在邏輯複迴歸分析中發現，與良好遵醫囑性有相關的變項爲男性，較少的每日降血壓藥使用頻次、每月收入小於一萬元者、近一年內曾做過健康檢查者、認爲吃藥對疾病有或非常有幫忙者以及半年內未曾發生藥物副作用者。
台南市老年高血壓患者的良好服藥遵醫囑率爲57.6%。爲提升老年高血壓患者的服藥遵醫囑率，醫師宜選用長效型降壓藥、讓患者瞭解藥物對高血壓控制的重要性以及避免藥物副作用的發生。

關鍵字

服藥遵醫囑性 ； 高血壓 ； 老年人 ； 社區型研究

並列摘要

Background/Purpose: Hypertension is an independent risk factor for cardiovascular disease with its prevalence among the elderly exceeding 60% in many countries while less than 30% were under control. Medication nonadherence has been identified as an important factor for therapeutic failure. We have accordingly conducted this community-based study to measure the medication adherence rate and explore its associated factors among elderly hypertensives in Tainan, a city in southern Taiwan.
Methods: This is a cross-sectional study with stratified cluster sampling design in 1995. Of the 876 participants (response rate 70.2%) aged 65 years and above, 144 subjects who received prescriptive antihypertensives were enrolled. Subjects taking 80% or more of their prescribed medicines were placed in the adherent group.
Results: The medication adherence rate was 57.6%. In univariate analyses, factors associated significantly with better adherence include: lower daily dose frequency, health examination in the previous year, belief in the efficacy of antihypertensives, absence of sufferings from adverse drug reactions in the past 6 months, and receipt from physicians of more explanations about adverse drug effects. As indicated by the results of multiple logistic regression analyses, the best predictive variables for medication adherence were male in gender, lower daily dose frequency, lower amount of monthly income, health examination in the previous year, belief in the efficacy of antihypertensives, and absence of adverse drug reaction in the past 6 months.
Conclusions: The drug adherence rate among elderly in anti-hypertensives in Tainan City reads 57.6%. To improve medication adherence, doctors should prescribe long-acting medications, emphasize the efficacy of medicines, and reduce the occurrence of adverse drug effects.

並列關鍵字

community-based ； elderly ； hypertension ； medication adherence