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Acta Facultatis Medicae Naissensis
2013, vol. 30, br. 4, str. 209-218
jezik rada: engleski
vrsta rada: izvorni naučni članak
Adherencija bolesnika sa arterijskom hipertenzijom
aUniverzitet u Nišu, Medicinski fakultet
bMedicinski fakultet, Odsek za farmaciju, Niš + Klinički centar, Odsek za farmakoterapiju, Niš + Klinički centar, Klinika za nefrologiju, Niš
cKlinički centar Niš

e-adresa: lalic.jelena@gmail.com

Sažetak

Stepen saradnje bolesnika ima ključnu ulogu u uspešnosti antihipertenzivne farmakoterapije. Neadherentnost predstavlja veliki zdravstveni i ekonomski problem u lečenju hipertenzije. Cilj istraživanja bio je evaluacija stepena adherencije kod bolesnika sa arterijskom hipertenzijom, utvrđivanje faktora rizika za neadherentnost i uticaj neadherentnosti na krvni pritisak. Urađena je studija preseka, kojom je obuhvaćeno 170 bolesnika sa arterijskom hipertenzijom, lečenih u primarnoj zdravstvenoj zaštiti u Niskom regionu, u južnoj Srbiji. Bolesnici su podeljeni u dve grupe, zavisno od stepena adherence, utvrđenog na osnovu sprovedenog validiranog upitnika. Za statističku analizu podataka korišćeni su Studentov T-test i Hi-kvadrat test. Zadovoljavajući nivo adherencije zabeležen je kod 126 (74.12%) bolesnika. Stariji bolesnici, sa dužim trajanjem hipertenzije i većim brojem lekova u terapiji pokazali su niži stepen adherencije, sa većim brojem neželjenih efekata (p<0.01). Bolesnici mlađi od 65 godina bili su adherentniji u poređenju sa starijim bolesnicima (χ2=21.3; p<0.01; OR=6.0 95%, CI 2.76-13.04). Loše kontrolisan krvni pritisak zabeležen je u značajno većem procentu kod neadherentnih bolesnika (59.1%), u poređenju sa adherentnom grupom (21.4%) (χ2=19.84; p<0.01; OR=5.30 95%, CI 2.39-11.85). Najčešći razlog niskog stepena adherencije bio je nepridržavanje režima doziranja (27.27%). Kod starijih bolesnika utvrđen je niži stepen adherencije. Ustanovljeno je da neadherentnost negativno utiče na kontrolu krvnog pritiska. Utvrđivanje faktora neadherentnosti i razvoj multidisciplinarnih interventnih programa za uticaj na identifikovane faktore neophodni su za poboljšanje adherencije i krvnog pritiska.
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Ključne reči

adherencija; arterijska hipertenzija; faktori neadherentnosti

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