| Objective:To describe the status and characteristics of medication adherence in patients with hypertension as well as sense of coherence (SOC), health promoting behavior (HPB) and to explore the relationships of SOC, HPB with medication adherence.Methods:235patients with hypertensive who accept treatment over six months were investigated in three community hospitals of Jinan City, Shandong Province from June2010to2011September, using the general information questionnaire, Morisky Medication Adeherence Scale, Sense of Coherence Scale (SOC-13) and Health-Promoting Lifestyle Profile Ⅱ(HPLP Ⅱ) by cross-sectional study. SPSS16.0was applied to analyze the data collated.Results:1. In235patients with hypertension, medication adherence of43cases (18.3%) was good, medication adherence of192cases (81.7%) was poor,80cases (34.0%) get0points for Morisky Medication Adeherence Scale. In four common reasons impacting medication compliance166cases (70.6%) missed dose,141cases (60.0%) did not pay attention to take medicine,141cases (60.0%) discontinued to take medicine when symptoms improved,128cases (54.5%) discontinued to take medicine when the symptoms deteriorated.2. The differences of medication adherence in the general data of patients with hypertension had statistical significance. The medication adherence of retired patients was better than working patients; The medication adherence of patients who had high blood pressure more than and equal to10years was better than the patients less than10years; The medication adherence of patients without complications was better than patients with complications; The medication adherence of patients whose blood pressure less than and equal to150mmHg was better than patients whose blood pressure didn t control; The medication adherence of patients who took one kind of antihypertensive drug was better than patients who took more than two kinds of drugs.3. Total score of SOC of patients with hypertension was58.69±10.20, and the entry average score of each dimension were4.51±0.78. The scores of comprehensibility, manageability, meaningfulness of patients with hypertension were21.84±4.61,17.77±3.93,19.06±3.67. The scores in descending order for meaningfulness, manageability, comprehensibility was4.76±0.91,4.44±0.98,4.36±0.92. The differences of medication adherence among patients with different scores of SOC and patients with different scores of comprehensibility, manageability, meaningfulness were all significant statistically (P<0.01). The patients whose SOC was low-level had the highest percentage (87.5%) of poor medication adherence. The patients whose comprehensibility, manageability, meaningfulness was low-level had the highest percentage (91.3%,88.0%,90.8%) of poor medication adherence respectively. The patients whose SOC was high-level had the highest percentage (45.7%) of good medication adheren. The patients whose comprehensibility, manageability, meaningfulness was high-level had the highest percentage (36.5%,46.2%,46.4%) of good medication adheren respectively.4. Total score of HPB of patients with hypertension was135.49±19.40, and the entry average score of each dimension was2.60±0.37. The scores of health responsibility, physical activity, interpersonal relations, stress management, spiritual growth, nutrition of patients with hypertension were21.78±4.59,19.25±4.40,24.24± 4.06,21.06±3.86,24.89±4.50,24.25±3.72. The scores in descending order for spiritual growth, interpersonal relations, nutrition, stress management, health responsibility, physical activity were2.76±0.50,2.69±0.45,2.69±0.41,2.63±0.48,2.42±0.51,2.40±0.55. The differences of medication adherence among patients with different scores of HPB and different scores of interpersonal relations, nutrition, stress management, health responsibility, physical activity were all not significant statistically. The differences of medication adherence among patients with different scores of spiritual growth were significant statistically (P<0.05). The patients whose spiritual growth were excellent level had the highest percentage (38.5%) of good medication adherence.5. Non-conditional binary logistic regression analysis was applied (the entry level0.05, the remove level0.05).The dependent variable of logistic regression analysis was the medication adherence of patients with hypertension. The independent variables of logistic regression analysis were age, occupation, blood pressure control, blood pressure classification, duration of disease, complications, number of antihypertensive drugs types, SOC, spiritual growth of patients with hypertension. Logistic regression analysis showed five factors:occupation, duration of disease, complications, SOC, spiritual growth which impact the medication adherence of patient with hypertension.Conclusion:1. The medication adherence of patients with hypertension is in a low level. To improve the awareness of medication adherence and develop good behavior and consciousness of medication adherence, the education of medication adherence should be strengthened for the patients with complication, physical labor, taking more than two kinds of antihypertensive drugs and whose disease duration is less than10years, whose blood pressure isn’t controlled.2.The SOC of patients with hypertension is in a medium level. The SOC is positive correlated with medication adherence. The three dimensions:comprehensibility, manageability, meaningfulness of SOC are also positive correlated with medication adherence. Improving the SOC level of patients with hypertension may help to improve medication adherence. Taking targeted measures for each dimension of SOC may help to improve medication adherence.3. The HPB of patients with hypertension is in a good level. Spiritual growth is positive correlated with medication adherence. Taking targeted measures for spiritual growth may help to improve medication adherence. |
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