نوع مقاله: مقاله پژوهشی

نویسندگان

1 دانشجوی دوره کارشناسی ارشد، گروه آموزش بهداشت و ارتقای سلامت، دانشکده بهداشت، کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی یاسوج، یاسوج، ایران

2 دانشیار، مرکز تحقیقات عوامل اجتماعی موثر بر سلامت، دانشگاه علوم پزشکی یاسوج، یاسوج، ایران

3 دانشیار، مرکز تحقیقات ایدز شیراز، دانشگاه علوم پزشکی شیراز، شیراز، ایران

4 دانشجوی دکترای آموزش و ارتقای سلامت، دانشکده بهداشت دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه : تبعیت دارویی بیمار به معنای پایبندی بیمار به رعایت دستورات دارویی که شامل مصرف به موقع و درست داروهای تجویز شده توسط پزشک می شود، است. این مطالعه با هدف تعیین میزان تبعیت از مصرف داروهای ضدفشارخون در بیماران قلبی مراجعه کننده به درمانگاه امام رضا در شهر شیراز اجرا شد.مواد و روش : این مطالعه مقطعی که در سال 1396 بر روی 282 نفر از بیماران قلبی عروقی مراجعه کننده به درمانگاه امام رضا (ع) شهر شیراز که داروی ضد پرفشاری خون مصرف می کردند، انجام شد. برای گردآوری اطلاعات از پرسشنامه تبعیت دارویی موریسکی که برای جامعه ایرانی روا و پایا شده بود، استفاده شد. داده ها با استفاده از نرم افزار SPSS  و آزمون تی تست و آنوا تحلیل شدند.یافته ها: نتایج نشان داد تبعیت از داروهای ضدفشارخون در 95/76درصد از بیماران قلبی پایین بود. در حالی که 96/15 و 09/7 درصد از بیماران مورد مطالعه از تبعیت متوسط و بالای دارویی برخوردار بودند. بیشترین علل عدم تبیعیت از رژیم فشار خون خود در بیماران قلبی در این مطالعه فراموش کردن زمان مصرف دارو (2/76 درصد)، مصرف نامنظم دارو در طول مسافرت یا هنگام ترک منزل (8/63 درصد) و خستگی ناشی از مصرف روزانه و مستمر دارو  (5/58 درصد) بود. به علاوه نتایج نشان داد با افزایش سن تبعیت دارویی کاهش می یافت (001/0>P، 22/0- = r).بحث و نتیجه گیری: این مطالعه نشان داد که بیش از دو سوم بیماران قلبی تبعیت پایینی از رژیم درمانی داروهای ضد فشارخون داشتند. علل شایع آن، فراموشی  و یا عدم مصرف دارو در مسافرت بود. ارائه راهکارهایی در این زمینه برای رفع این مشکل پیشنهاد می شود.

کلیدواژه‌ها

عنوان مقاله [English]

Antihypertensive Drugs Adherence in Heart Disease Patients Referring to the Imam Reza Clinic in Shiraz

نویسندگان [English]

  • Somayeh Zare 1
  • Mohsen Shams 2
  • Mohammad Fararouei 3
  • Sadigheh Shariatinia 4

1 MS, Student Research Committee, Yasuj University of Medical Sciences, Yasuj, Iran

2 PhD, Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran

3 PhD, Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

4 PhD Student, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

چکیده [English]

Back ground: Patient medication adherence refers to the timely and correct use of medications prescribed by the physician. The aim of this study was to determine the adherence rate of antihypertensive drugs in heart disease patients referring to the Imam Reza Clinic in Shiraz, Iran.
Methods: This cross-sectional study was performed on 282 heart disease patients, who used antihypertensive, referring to Imam Reza (AS) clinic in Shiraz in 1396. For data collection, a demographic questionnaire and a Morisky Medication Adherence Scale, which was valid for the Iranian community, were used. Data were analyzed using SPSS software.
Results: The results of this study revealed that the antihypertensive drug adherence in 95 heart disease patients (76%) was low.  However, 16% and 7% of the patients reported moderate and high adherence to antihypertensive drugs, respectively. The most common causes of patients’ antihypertensive drug non-adherence were forgetting to take the medication (76.2 %), irregular taking of the medication while traveling (63.8) or while leaving the house, and being tired as a result of daily and continually taking the drugs (58.5 %). Moreover, the results showed that by aging, the antihypertensive drug adherence decreased (r= - 0.22, P < 0.001).
Conclusion: This study showed that more than two-thirds of heart disease patients had low medication adherence. The most common causes were missed medication and irregular travelling-related medication intake. Performing some strategies for solving this issue is recommended. 

کلیدواژه‌ها [English]

  • Medication adherence
  • Antihypertensive agents
  • Heart diseases

  1. Kazemy T, Sharifzadeh GH. The proportion of CVD from total death in Birjand 2002-2003. The Journal of Qazvin University of Med Sciences 2005; 33: 73-76 (Persian).
  2. Baljani E, Rahimi Zh, Heidari SH, Azimpour A. The effects of self-management interventions on medication adherence and life style in cardiovascular patients. Scientific Journal of Hamedan Burs Midwifery Faculty 2012; 20(3): 58-68 (Persian).
  3. Donyavi T, Naieni Kh, Nedjat S, Vahdaninia M, Najafi M, Montazeri A. Socioeconomic status and mortality after acute myocardial infarction: A study from Iran. International Journal for Equity in Health. 2011; 10: 9.
  4. Bobrow K, Brennan T, Springer D, Levitt NS, Rayner B, Namane M, et al. Efficacy of a text messaging (SMS) based intervention for adults with hypertension: protocol for the STAR (SMS Text-message Adherence support trial) randomized controlled trial. BMC public health 2014; 14: 28.
  5. Theodor A, Harrison T. Hypertensive vascular diseases. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson L, Loscalzo J (editors). Harrison's principles of internal medicine. 18th ed. Machgra H; 2012; 2054-2058.
  6. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289(19): 2560-2571.
  7. Hinkle JL, Cheever KH. Brunner & Suddarth's Medical-Surgical Nursing.1th ed. Tehran: Heidary; 2014. P: 358-388
  8. Centers for Disease Control and Prevention (CDC). Vital signs: awareness and treatment of uncontrolled hypertension among adults--United States, 2003-2010. MMWR Morb Mortal Wkly Rep. 2012; 61:703-9.
  9. Ogedegbe G, Schoenthaler A, Richardson T, Lewis L, Belue R, Espinosa E, et al. An RCT of the effect of motivational interviewing on medication adherence in hypertensive African Americans: Rationale and design. Contemporary Clinical Trials 2007; 28(2):169-181.
  10. Arbabshastan ME. To assess relationship between medication adherence and belief about medication in hypertensive patients referred to the health resource centers in Zahedan 2015. 2015. MSc Thesis on Nursing Education, Faculty of Nursing and Midwifery, Kerman University of Medical Sciences. (Persian)
  11. Wald DS, Bestwick JP, Raiman L, Brendell R, Wald NJ. Randomized trial of text messaging on adherence to cardiovascular preventive treatment (INTERACT trial). PloS one 2014; 9(12): 114268.
  12. National Stroke Association. Medication adherence and compliance 2012. http://www.stroke.org/stroke-resources/library/medication-adherence-and-compliance. Cited in June 9; 2018.
  13. Kripalani S, Schmotzer B, Jacobson TA. Improving medication adherence through graphically enhanced interventions in coronary heart disease (IMAGE-CHD): A randomized controlled trial. Journal of General Internal Medicine 2012; 27(12): 1609-1617.
  14. Asefzadeh S, Asefzadeh M, Javadi HR. Adherence to medical advice in patients referred to Bu Ali Sina-Qazvin Clinic. Research in Medical Science 2005; 10(6): 403 (Persian).
  15. Vervloet M, Linn AJ, van Weert JC, De Bakker DH, Bouvy ML, Van Dijk L. The effectiveness of interventions using electronic reminders to improve adherence to chronic medication: A systematic review of the literature. Journal of the American Medical Informatics Association 2012; 19(5): 696-704.
  16. Kripalani S, Yao X, Haynes RB. Interventions to enhance medication adherence in chronic medical conditions: a systematic review. Archives of internal medicine 2007; 167(6): 540-549.
  17. Gould E, Mitty E. Medication adherence is a partnership, medication compliance is not. Geriatric Nursing. 2010; 31(4): 290-298.
  18. Delamater AM. Improving patient adherence. Clinical diabetes 2006; 24(2): 71-77. 
  19. Doosti Irani M, Abazari P, Babaei S, Shahgholian N. Facilitators of adherence to self-management in type 2 diabetic patients: A phenomenological study. Iranian Journal of Endocrinology and Metabolism 2009; 11(3): 257-264 (Persian).
  20. Rashedi E, Sohrabi F, Shams J. A Study of the Efficacy of Cognitive Behavior Therapy in Relapse Prevention of Bipolar. Clinical Psychology & Personality 2011; 2(5): 49-64 (Persian).
  21. Ma C. A cross-sectional survey of medication adherence and associated factors for rural patients with hypertension. Applied Nursing Research 2016; 31: 94-99.
  22. Shahinzadh A, Elahi N, Jahani S, Hakim A. Relationship of personal- social and therapeutic factors with medication compliance in TB patients in Ahwaz. Journal of Shahid Sadoughi University of Medical Sciences 2012; 19(6): 726-735 (Persian).
  23. Ezeala-Adikaibe BA, Mbadiwe N, Okudo G, Nwosu N, Nwobodo N, Onyebueke G, et al. Factors associated with medication adherence among hypertensive patients in a tertiary health center: A cross-sectional study. Archives of Community Medicine and Public Health 2017; 3(1): 24-311.