A study on relationship between compliance with anti-hypertension therapy and assessment of quality of health care in patients with hypertension in community / 中华预防医学杂志

ABSTRACT

<p><b>OBJECTIVE</b>To study the relationship between compliance with anti-hypertension therapy and assessment of quality of health care in hypertensive patients in community.</p><p><b>METHODS</b>According to multi-stage cluster random sampling, we selected two communities from 36 streets in certain areas of Shanghai respectively using random number method on May, 2013, 72 communities in total, then we randomly selected 25 patients who were archived in the community health center from each community of the street.We conducted 1 800 questionnaires in total in which 1 172 patients were under medication study. The Morisky Medication Adherence Scale was used to evaluate medication compliance while the Patient Assessment of Chronic Illness Care Scale was applied to measuring the quality of patient's self-reported health service. The Spearman rank correlation analysis was used to evaluate the relationship between assessment of quality of health care for chronic illness and compliance with anti-hypertension therapy. Binary logistic analysis was applied to evaluate the factors which influenced patient's medicine compliance.</p><p><b>RESULTS</b>There were 567(48.4%) respondents with good compliance. Age less than or equal to 65 accounted for 43.3% (245 people) while age greater than 65 accounted for 56.7% (321 people). The average scores of total and difference dimensions remained at a low level, ranging from 1.97 to 2.67 out of 5. The Assessment of quality of health care score was (2.67 ± 1.33)scores, in which the highest score of the dimensions was patient activation which was (2.56 ± 1.41)scores and the lowest was follow-up / collaboration which was (1.97 ± 1.49)scores. The Spearman rank correlation analysis showed that negative association between accumulate points of patient medicine compliance and patient activation was found (rs = -0.09, P < 0.01). The result of binary logistic analysis indicated that medication adherence of age greater than 65 was 1.49 times (95%CI 1.11-2.00) higher than age less than or equal to 65. The patient activation was a protective factors of good medicine adherence (OR = 1.35, 95%CI1.14-1.59).</p><p><b>CONCLUSIONS</b>The medicine adherence of hypertension patients in community medication compliance is not very good at the moment. The self-rated quality of health care is still relative poor. Positive activation from interaction of physicians and patients can help enhancing patient's medicine compliance.</p>