The Current Status and Influencing Factors of Treatment Adherence to National Chronic Disease Management Services for Hypertensive Population in a Community Healthcare Center in Guangzhou

Abstract

Background The hypertensive population has a large base in China, and its preventive and treatment measures rely mainly on the chronic disease management service program within the National Basic Public Health Service. However, current studies have shown low utilization rate of it, so it is of great significance for improving the participation of the National Chronic Disease Management Service and health level in the hypertensive population to conduct a survey of participants to determine the factors affecting their treatment adherence. Objective To investigate and analyze the current status and influencing factors of treatment adherence of hypertension management services within the National Basic Public Health Service, and provide reference for improving treatment adherence in hypertensive patients. Methods A total of 295 participants of hypertension management services in the community served by a community healthcare center in Guangzhou City from June to September 2022 as the study subjects by using a multi-stage sampling method. The General Information Questionnaire and the Emotional Balance Scale (positive and negative emotions) were used to investigate the basic information of the study subjects, and the Hypertension Treatment Adherence Scale was used to investigate the current status of treatment adherence among the study subjects. Multivariate Logistic regression analysis was used to explore the influencing factors of treatment adherence to the National Chronic Disease Management Service in the hypertensive population, and the influence of the combined positive and negative emotion status on treatment adherence to the National Chronic Disease Management Service in the hypertensive population. Results A total of 310 valid questionnaires were distributed, 295 valid questionnaires were recovered, with a validity rate of 95.2%; the total score of the Hypertension Treatment Adherence Scale was (94.24±8.67), of which the score of medication adherence was (21.06±2.45), medication malpractice was (31.33±3.90), tobacco and alcohol management was (8.44±1.88), and management of daily life was (33.41±4.61), with good adherence rate of 52.2% (154/295) ; the positive emotion score in the Emotional Balance Scale was (3.76±1.02), and the negative emotion score was (2.63±1.12) ; the results of multivariate Logistic regression analysis showed that gender, age, BMI, education level, blood pressure control, self-perceived physical condition, satisfaction with the point of care, more positive emotions and less negative emotions were the influencing factors for good treatment adherence to the National Chronic Disease Management Service in the hypertensive population (P<0.05) ; treatment adherence to the National Chronic Disease Management Service in the hypertensive population with a combined status of more positive and less negative emotions was 15.867 times higher than that of less positive and more negative emotions (P<0.05), and the treatment adherence with the combined status of more positive and more negative emotions was 5.114 times higher than that of less positive and more negative emotions (P<0.05) . Conclusion There is still room for improving treatment adherence to the National Chronic Disease Management Service for hypertensive patients. In addition to objective factors such as gender and age, there is also a need to focus on the emotional management, feedback effect of the treatment and the experience of patients in community healthcare canters.

Keywords

• hypertension|treatment adherence and compliance|chinese basic public health services|management of chronic disease|positive and negative emotions|root cause analysis