中国大陆地区2006—2016年高血压患者服药依从率meta分析
|
摘要
目的了解中国大陆地区2006—2016年高血压患者的服药依从率,为制定合适的公共卫生政策以提高高血压患者的服药依从率提供参考依据。方法检索中国知网数据库、万方数据库、维普中国科技期刊数据库和PubMed数据库,并辅以文献追溯法收集2006年1月1日—2016年12月31日公开发表的关于中国大陆地区高血压患者服药依从率的相关文献,应用Stata 12.0软件对纳入的文献进行meta分析。结果最终纳入19篇中文文献,累计研究对象44 322例。meta分析结果显示,中国大陆地区高血压患者服药依从率为42.5%(95%CI=37.4%~47.6%)。亚组分析结果显示,城市高血压患者的服药依从率为44.5%,高于农村高血压患者的38.9%,差异有统计学意义(χ~2=57.254,P <0.001);东北部、东部、中西部高血压患者的服药依从率分别为36.9%、40.6%、47.9%,差异有统计学意义(χ~2=316.846,P <0.001);发表年份在2006—2011年文献中高血压患者的服药依从率为37.5%,低于发表年份在2012—2016年文献中的45.3%,差异有统计学意义(χ~2=68.852, P <0.001);高质量文献中高血压患者的服药依从率为40.5%,低于中低质量文献中的50.8%(χ~2=33.095, P <0.001)。Begg′s检验和Egger′s检验结果均显示本次纳入meta分析的文献不存在发表偏倚(均P> 0.05)。结论中国大陆地区高血压患者服药依从性较差,应深入研究影响高血压患者服药依从性的因素,以利于相关部门采取更有针对性的干预措施提高患者的服药依从率。
Objective To analyze medication adherence rates among hypertensive patients in mainland China from 2006 to 2016 and to provide evidences for developing appropriate public health strategies to increase medication adherence of the patients. Methods We searched PubMed database, China National Knowledge Infrastructure database, WanFang Database,VIP Database, supplemented by literature retrospective method, to collect literatures on medication compliance of among community hypertensive patients in mainland China from January 1, 2006 to December 31, 2016; then we conducted a metaanalysis with Stata 12.0 software. Results A total of 19 studies were included, involving 44 322 participants. Among the participants, the pooled medication adherence rate was 42.5%(95% confidence interval [95% CI]: 37.4%-47.6%). The medication adherence rate was statistically higher in the urban patients than in the rural patients(44.5% vs. 38.9%, χ~2 =57.254, P < 0.001). The medication adherence rates were 36.9%, 40.6%, and 47.9% among the hypertensive patients in north-eastern, eastern, and central-western China, respectively, with a significant difference(χ~2 = 316.846, P < 0.001). The pooled medication adherence rate for the studies published between 2006 and 2011, was significantly lower than that(45.3%)for the studies published between 2012 and 2016(χ~2 = 68.852, P < 0.001); the medication adherence rate pooled based on the studies of high quality was significantly lower than that pooled based on the studies of moderate and low quality(40.5% vs50.8%, χ~2 = 33.095; P < 0.001). There was no statistically significant publication bias for the included studies based on Begg′s test and Egger′s test(both P > 0.05). Conclusion The medication adherence is poor among hypertensive patients in mainland China, suggesting that further studies are needed to explore related factors of medication adherence for developing targeted interventions on increasing medication adherence rate in hypertensive patients.
Objective To analyze medication adherence rates among hypertensive patients in mainland China from 2006 to 2016 and to provide evidences for developing appropriate public health strategies to increase medication adherence of the patients. Methods We searched PubMed database, China National Knowledge Infrastructure database, WanFang Database,VIP Database, supplemented by literature retrospective method, to collect literatures on medication compliance of among community hypertensive patients in mainland China from January 1, 2006 to December 31, 2016; then we conducted a metaanalysis with Stata 12.0 software. Results A total of 19 studies were included, involving 44 322 participants. Among the participants, the pooled medication adherence rate was 42.5%(95% confidence interval [95% CI]: 37.4%-47.6%). The medication adherence rate was statistically higher in the urban patients than in the rural patients(44.5% vs. 38.9%, χ~2 =57.254, P < 0.001). The medication adherence rates were 36.9%, 40.6%, and 47.9% among the hypertensive patients in north-eastern, eastern, and central-western China, respectively, with a significant difference(χ~2 = 316.846, P < 0.001). The pooled medication adherence rate for the studies published between 2006 and 2011, was significantly lower than that(45.3%)for the studies published between 2012 and 2016(χ~2 = 68.852, P < 0.001); the medication adherence rate pooled based on the studies of high quality was significantly lower than that pooled based on the studies of moderate and low quality(40.5% vs50.8%, χ~2 = 33.095; P < 0.001). There was no statistically significant publication bias for the included studies based on Begg′s test and Egger′s test(both P > 0.05). Conclusion The medication adherence is poor among hypertensive patients in mainland China, suggesting that further studies are needed to explore related factors of medication adherence for developing targeted interventions on increasing medication adherence rate in hypertensive patients.
引文
[1]Hamrahian SM.Management of hypertension in patients with chronic kidney disease[J].Current Hypertension Reports,2017,19(5):43.
[2]韦庆瑶,樊秀郁,韦汉杰,等.高血压患者服药依从性研究的进展分析[J].中国保健营养,2017,27(1):72.
[3]Corrao G,Parodi A,Nicotra F,et al.Better compliance to antihypertensive medications reduces cardiovascular risk[J].Journal of Hypertension,2011,29(3):610-618.
[4]戴俊明,傅华,沈贻谔.原发性高血压药物治疗依从性研究[J].中国慢性病预防与控制,2000,8(3):143-145.
[5]周波,陈欣,时景璞,等.率的Meta分析及软件实现[J].中国循证医学杂志,2014,14(8):1009-1016.
[6]董永海,毛向群,刘磊,等.中国老年期痴呆患病率Meta分析[J].中国公共卫生,2014,30(4):512-515.
[7]陈文如,黄小平,郑建宏,等.深圳市上梅林新村常住人口高血压患者服药依从性调查[J].中国组织工程研究,2004,8(27):5790-5791.
[8]刘梓廉,张冰玲,王丽香,等.深圳市盐田区社区高血压病人药物治疗依从性及影响因素[J].中国慢性病预防与控制,2008,16(1):70-71.
[9]陆焕章,陈建英,陈灿.广东农村常住人口高血压患者服药依从性现况调查[J].中外医疗,2009,28(21):121.
[10]李坤,梁会营,李恂,等.沈阳市社区高血压患者服药依从性现状及影响因素分析[J].中国慢性病预防与控制,2010,18(6):584-586.
[11]刁文丽,刘莉,于丽娅,等.辽宁省农村高血压患者服药依从性与血压控制水平研究[J].中国慢性病预防与控制,2010,18(4):338-340.
[12]王大鹏,张春梅,侯杰.沈阳市兴工街道社区高血压患者服药依从性影响因素分析[J].中国民康医学,2010,22(12):1516.
[13]孙雯雯,顾清.天津市社区中老年高血压患者服药依从性及卫生服务利用情况[J].职业与健康,2011,27(9):1039-1040.
[14]常慧,田丹,任旭,等.辽宁省农村高血压患者服药依从性调查及影响因素分析[J].中国健康教育,2012,28(3):167-169.
[15]赵利娟.华泾镇高血压患者服药依从性调查分析[J].上海医药,2013,34(6):55-57.
[16]阮蕾,秦方,闫亚非,等.成都市社区高血压患者治疗依从性调查及影响因素[J].四川医学,2012,33(8):1333-1335.
[17]秦林原.兰州市七里河农村地区居民高血压患病及治疗依从状况研究[D].兰州:兰州大学,2013.
[18]任慧,盛新春,张华,等.社区高血压患者药物治疗依从性与自评获得卫生服务质量关联研究[J].中华预防医学杂志,2014,48(5):345-349.
[19]王艺英,叶翠华.社区高血压患者服药依从性的调查及护理对策[J].中国实用医药,2014,9(16):210-211.
[20]魏威,熊巨洋,童雪涛,等.贵阳市高血压患者药物依从性及其影响因素研究[J].医学与社会,2014,27(1):11-13.
[21]赵玉珍.农村高血压人群药物治疗依从性及影响因素探讨[J].心血管病防治知识,2015(3):6-8.
[22]童海宁,张竞超.社区高血压患者用药依从性及影响因素研究[J].中国药房,2015(11):1571-1573.
[23]豆瑜奎.甘肃省农村高血压患者药物治疗依从性研究及影响因素分析[J].疾病预防控制通报,2015,30(1):4-6.
[24]刘建华,杜鹃.北京市边远山区农村高血压患者用药情况现状调查[J].临床药物治疗杂志,2016,14(3):40-43.
[25]苏宇,涂忆桥,李俊林,等.武汉市社区高血压患者药物依从性及其影响因素分析[J].中国公共卫生,2016,32(7):920-924.
[26]杨娟,郑青山.Meta分析的统计学方法[J].中国临床药理学与治疗学,2005,10(11):1309-1314.
[27]石果,张顺祥.我国孕妇乙肝表面抗原阳性率的Meta分析[J].中国预防医学杂志,2013,14(1):26-30.
[28]艾聪,李光校,周波,等.中国2000年后急性心肌梗死患者抑郁患病率的Meta分析[J].中国循证医学杂志,2017,17(1):47-51.
[29]金楠,李革,李会,等.中国大陆地区成年人高血压前期发生率及危险因素的meta分析[J].南方医科大学学报,2013,33(12):1738-1743.
[30]Alhaddad IA,Hamoui O,Hammoudeh A,et al.Treatment adherence and quality of life in patients on antihypertensive medications in a Middle Eastern population:adherence[J].Vascular Health and Risk Management,2016,12:407-413.
[31]Korbsavoldelli V,Gillaizeau F,Pouchot J,et al.Validation of a French version of the 8-item Morisky Medication Adherence Scale in hypertensive adults[J].Journal of Clinical Hypertension,2012,14(14):429-434.
[32]de Oliveira-Filho AD,Morisky DE,Neves SJ,et al.The 8-item Morisky Medication Adherence Scale:validation of a BrazilianPortuguese version in hypertensive adults[J].Research in Social and Administrative Pharmacy Rsap,2014,10(3):554-561.
[33]王平,曾慧.高血压患者服药依从性研究进展[J].中国全科医学,2011,14(7):772-775.
[2]韦庆瑶,樊秀郁,韦汉杰,等.高血压患者服药依从性研究的进展分析[J].中国保健营养,2017,27(1):72.
[3]Corrao G,Parodi A,Nicotra F,et al.Better compliance to antihypertensive medications reduces cardiovascular risk[J].Journal of Hypertension,2011,29(3):610-618.
[4]戴俊明,傅华,沈贻谔.原发性高血压药物治疗依从性研究[J].中国慢性病预防与控制,2000,8(3):143-145.
[5]周波,陈欣,时景璞,等.率的Meta分析及软件实现[J].中国循证医学杂志,2014,14(8):1009-1016.
[6]董永海,毛向群,刘磊,等.中国老年期痴呆患病率Meta分析[J].中国公共卫生,2014,30(4):512-515.
[7]陈文如,黄小平,郑建宏,等.深圳市上梅林新村常住人口高血压患者服药依从性调查[J].中国组织工程研究,2004,8(27):5790-5791.
[8]刘梓廉,张冰玲,王丽香,等.深圳市盐田区社区高血压病人药物治疗依从性及影响因素[J].中国慢性病预防与控制,2008,16(1):70-71.
[9]陆焕章,陈建英,陈灿.广东农村常住人口高血压患者服药依从性现况调查[J].中外医疗,2009,28(21):121.
[10]李坤,梁会营,李恂,等.沈阳市社区高血压患者服药依从性现状及影响因素分析[J].中国慢性病预防与控制,2010,18(6):584-586.
[11]刁文丽,刘莉,于丽娅,等.辽宁省农村高血压患者服药依从性与血压控制水平研究[J].中国慢性病预防与控制,2010,18(4):338-340.
[12]王大鹏,张春梅,侯杰.沈阳市兴工街道社区高血压患者服药依从性影响因素分析[J].中国民康医学,2010,22(12):1516.
[13]孙雯雯,顾清.天津市社区中老年高血压患者服药依从性及卫生服务利用情况[J].职业与健康,2011,27(9):1039-1040.
[14]常慧,田丹,任旭,等.辽宁省农村高血压患者服药依从性调查及影响因素分析[J].中国健康教育,2012,28(3):167-169.
[15]赵利娟.华泾镇高血压患者服药依从性调查分析[J].上海医药,2013,34(6):55-57.
[16]阮蕾,秦方,闫亚非,等.成都市社区高血压患者治疗依从性调查及影响因素[J].四川医学,2012,33(8):1333-1335.
[17]秦林原.兰州市七里河农村地区居民高血压患病及治疗依从状况研究[D].兰州:兰州大学,2013.
[18]任慧,盛新春,张华,等.社区高血压患者药物治疗依从性与自评获得卫生服务质量关联研究[J].中华预防医学杂志,2014,48(5):345-349.
[19]王艺英,叶翠华.社区高血压患者服药依从性的调查及护理对策[J].中国实用医药,2014,9(16):210-211.
[20]魏威,熊巨洋,童雪涛,等.贵阳市高血压患者药物依从性及其影响因素研究[J].医学与社会,2014,27(1):11-13.
[21]赵玉珍.农村高血压人群药物治疗依从性及影响因素探讨[J].心血管病防治知识,2015(3):6-8.
[22]童海宁,张竞超.社区高血压患者用药依从性及影响因素研究[J].中国药房,2015(11):1571-1573.
[23]豆瑜奎.甘肃省农村高血压患者药物治疗依从性研究及影响因素分析[J].疾病预防控制通报,2015,30(1):4-6.
[24]刘建华,杜鹃.北京市边远山区农村高血压患者用药情况现状调查[J].临床药物治疗杂志,2016,14(3):40-43.
[25]苏宇,涂忆桥,李俊林,等.武汉市社区高血压患者药物依从性及其影响因素分析[J].中国公共卫生,2016,32(7):920-924.
[26]杨娟,郑青山.Meta分析的统计学方法[J].中国临床药理学与治疗学,2005,10(11):1309-1314.
[27]石果,张顺祥.我国孕妇乙肝表面抗原阳性率的Meta分析[J].中国预防医学杂志,2013,14(1):26-30.
[28]艾聪,李光校,周波,等.中国2000年后急性心肌梗死患者抑郁患病率的Meta分析[J].中国循证医学杂志,2017,17(1):47-51.
[29]金楠,李革,李会,等.中国大陆地区成年人高血压前期发生率及危险因素的meta分析[J].南方医科大学学报,2013,33(12):1738-1743.
[30]Alhaddad IA,Hamoui O,Hammoudeh A,et al.Treatment adherence and quality of life in patients on antihypertensive medications in a Middle Eastern population:adherence[J].Vascular Health and Risk Management,2016,12:407-413.
[31]Korbsavoldelli V,Gillaizeau F,Pouchot J,et al.Validation of a French version of the 8-item Morisky Medication Adherence Scale in hypertensive adults[J].Journal of Clinical Hypertension,2012,14(14):429-434.
[32]de Oliveira-Filho AD,Morisky DE,Neves SJ,et al.The 8-item Morisky Medication Adherence Scale:validation of a BrazilianPortuguese version in hypertensive adults[J].Research in Social and Administrative Pharmacy Rsap,2014,10(3):554-561.
[33]王平,曾慧.高血压患者服药依从性研究进展[J].中国全科医学,2011,14(7):772-775.