A Nomogram-based Analysis on Medication Adherence of Hypertensive Patients in China

다국어 초록 (Multilingual Abstract)

Purpose: In order to analyze the influencing factors of medication adherence in Chinese hypertensivepatients, a nomogram of medication adherence in hypertensive patients was constructed in this paper,which may provide a foundation for the establishment of a simple method for predicting medicationadherence in hypertensive patients.
Methods: We enrolled 297 hypertensive patients in a tertiary care hospital in Wuhu City. Medicationadherence was assessed using the 4-item Medication Adherence Scale. Patients were categorized into theadherence group and poor medication adherence group based on their scores. We used logisticregression to identify factors influencing medication adherence. The predictors were analyzed bynomogram method using R software. Its effectiveness was assessed by the area under the curve (AUC) ofthe receiver operating characteristic curve (ROC) and the calibration curve to evaluate its discriminatorypower and accuracy.
Results: Of the 297 patients, 111 (37.4%) had good medication adherence, and 186 (62.6%) had poormedication adherence. In the group with good medication adherence, there were 52 (46.8%) men and 48(43.3%) persons aged 65 years; in the group with poor medication adherence, there were 101 (54.3%)men and 92 (49.4%) persons aged 65-80 years. Place of residence, Acceptance of the disease, Satisfactionwith family functioning, Frailty, and E-health literacy were factors influencing adherence to medicationin hypertensive patients (p < .05); The predictors were incorporated into the R software to establish anomogram of medication adherence in hypertensive patients, and its test showed an AUC of .83 (95% CI:0.79-0.88); Hosmer-Lemeshow goodness-of-fit test showed c2 ¼ 4.78, p ¼ .78, which indicated that themodel had a high degree of differentiation and precision.
Conclusion: Overall, Chinese hypertensive patients had poor medication adherence. Medication adherencewas better among hypertensive patients who lived in a city, had higher disease acceptance, hadmore satisfactory family functioning, were not physically frail, and had higher e-health literacy. Theestablished nomogram has a good predictive value for medication adherence in hypertensive patients,reduces the medical burden on society and families, and provides a reference for clinical caregivers.