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.
引文
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