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Int J Cardiol: 医疗保险制度完善,服药依从性越好

2017-03-22 MedSci MedSci原创

背景:缺乏医疗保险可能对服药依从性及心血管危险因素的控制产生不利影响。研究者调查保险和LDL-C之间的相关性是否因为自我服药依从性低。方法:本研究包括脑卒中地理和种族差异的原因(REGARDS)队列研究中,8685例45岁以上的黑人和白人男性和女性,这些患者使用他汀类药物。应用MMAS-4评估服药依从性。校正MMSA-4前后,应用广义线性模型计算有无保险的受试者,LDL-C的差异。按年龄分层,家庭

背景:缺乏医疗保险可能对服药依从性及血管危险因素的控制产生不利影响。研究者调查医疗保险和LDL-C之间的相关性是否因为自我服药依从性低?

方法:本研究包括脑卒中地理和种族差异原因(REGARDS)队列研究中,8685例45岁以上使用他汀类药物患者,这些患者有黑人和白人,男性和女性。应用MMAS-4评估服药依从性。校正MMSA-4前后,应用广义线性模型计算有无医疗保险受试者的LDL-C的差异。按年龄,家庭年收入水平、糖尿病及冠心病分层。另外,对MMAS-4单独进行分析确定是否存在中介效应。

结果:多变量调整,未对MMAS-4时,无保险者的受试者LDL-C高于有保险的受试者2.5mg/dl(95% CI 0.6,5.6)。对MMAS-4进一步校正后,无保险者受试者的LDL-C高于有保险者2.6mg/dl(95% CI 0.5,5.6)。分层分析后,结果一致。对每个MMAS-4单独分析未发现中介作用。

结论:高服药依从性对健康保险和降低LDL-C的关系没有影响。

原文出处:

Mefford M, Safford MM,et al. Insurance, self-reported medication adherence and LDL cholesterol: The REasons for Geographic And Racial Differences in Stroke study. Int J Cardiol. 2017 Feb 22.


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    2017-03-24 fyxzlh
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    2017-03-24 xuyu
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    2017-03-24 feifers

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