• 농촌의학ㆍ지역보건
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• 제24권1호
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• pp.35-47
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• 1999

노인에서 처방약 복용에 대한 불순응의 문제는 의학적으로 심각한 문제의 발생과 경제적인 손실을 가져오게 된다. 이 연구는 1996년 7월 24 일부터 8월 13일 사이에 경상북도 김천시 금릉군에 거주하는 60세 이상의 농촌 노인을 대상으로 이루어진 단면적인 면접조사이다. 노인에서의 비고이적인 약물복용 불순응의 원인이 되는 약물복용 능력의 실태를 파악하고, 약물 복용능력과 건강상태, 일상적 생활 활동, 가족적 지지, 그리고 인지기능을 비롯한 다양한 변수, 일반적 특성 등과의 관련성을 조사 분석함으로써 약물 복용 실행능력을 예측할 수 있는 예측자를 찾고자 하였다. 현재 복용하고 있는 약물이 있다고 답한 사람은 48.8%였다. 93%가 혼자서 정확한 시간에, 정확한 용량으로 복용할 수 있다고 답하였고, 6%가 약간의 도움이 필요하다고 하거나 혼자 복용할 수 없다고 답하였다. 약물 복용 수행능력과 일반적 특성 및 연구 변수들간의 차이에는 연령과 교육수준, IADL, MMSE-K가 혼자서 독립적으로 복용할 수 없는 군 사이에 유의한 차이가 있었으며, 상관분석에는 ADL, IADL, MMSE-K, BDI가 유의한 상관이 있었다. 단일변수분석과 상관분석에서 약물 복용 능력과 유의한 관련성을 보인 변수를 선택하여 투입한 로지스틱 회귀분석에서 IADL과 성이 최종적으로 선택되었다. 다른 건강수준 측정법 보다 수단적 일상생활 정도는 약물복용 수행능력에 더 민감한 예측자로의 역할이 기대되므로 투약관리와 약물 복용 수행 능력에 대한 정신적 상태를 평가하는 고식적 방법에 추가정보를 제공할 수 있을것으로 판단된다. 추후 약물복용 순응도의 다면적인 면을 고려한 연구가 입 퇴원환자를 중심으로 한 정확한 투약 순응도와 규모 파악, 이를 향상시킬 수 있는 구체적인 방안을 모색하는 방향을 중재 연구와 인지기능 및 운동기등 등의 정신 및 신체조건에 따른 약물 복용 순응도에 초점이 맞춘 다양하고 집중적인 연구자 필요할 것으로 생각된다.

• 기본간호학회지
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• 제12권2호
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• pp.186-194
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• 2005

Purpose: The purpose of this study was to examine self care compliance, family support, and depression in patients with congestive heart failure. Method: The participants were 105 outpatients with congestive heart failure. Data were collected using a questionnaire survey on self care compliance, family support, and depression. The collected data were analyzed using the SPSS Win 10.0 program. Result: 1. The total score for Self care compliance was 78.34 out of a possible 120 and was significantly high for people in ages between 70-79 years and people who were not employed. Exercise compliance was significantly high in men and classifications I & II of the NYHA class. Compliance with smoking and alcohol cessation were significantly high in women. Medication compliance was significantly high in the group which had experience with hospitalization. Family support was 31.75 out of a possible 40 and showed significant differences depending on spouse status and religion. Depression was 30.18 out of a possible 64 and was significantly high in the group whose educational level was above college graduation or who were under 65 years of age. Conclusion: The results suggest that nurses have to emphasize smoking and alcohol cessation for men, exercise for women and total self care compliance for patients under 65 years of age.

• Genomics & Informatics
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• 제12권3호
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• pp.121-126
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• 2014

Medication adherence is generally defined as the extent of voluntary cooperation of a patient in taking medicine as prescribed. Adherence to long-term treatment with chronic disease is essential for reducing disease comorbidity and mortality. However, medication non-adherence in chronic disease averages 50%. This study was conducted a genome-wide association study to identify the genetic basis of medication adherence. A total of 235 medication non-adherents and 1,067 medication adherents with hypertension or diabetes were used from the Korean Association Resource project data according to the self-reported treatment status of each chronic disease, respectively. We identified four single nucleotide polymorphisms with suggestive genome-wide association. The most significant single nucleotide polymorphism was rs6978712 (chromosome 7, $p=4.87{\times}10^{-7}$), which is located proximal to the GCC1 gene, which was previously implicated in decision-making capability in drug abusers. Two suggestive single nucleotide polymorphisms were in strong linkage disequilibrium ($r^2$ > 0.8) with rs6978712. Thus, in the aspect of decision-making in adherence behavior, the association between medication adherence and three loci proximal to the GCC1 gene seems worthy of further research. However, to overcome a few limitations in this study, defining the standardized phenotype criteria for self-reported adherence should be performed before replicating association studies.

• 임상간호연구
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• 제16권1호
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• pp.155-166
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• 2010

Purpose: The purpose of the study was to examine the level and correlation of compliance and barriers to self-care behavior in patients with type 2 diabetes. Methods: The participants for this study were 122 patients with type 2 diabetes enrolled in the out-patient clinic of C national general hospital. Data collection was done by self-report questionnaires. Results: The mean score of the patients with type 2 diabetes for self-care behavior was higher than average level. Level of barriers to exercise was also higher than average, and higher than other barriers of diet and medication; There were low but significant correlations between self-care behavior and barriers to diet, exercise and medication; Variance in barriers to exercise, using alcohol, regular hospital visits, medical treatment and good foot care explained 29.6% of the variance in self-care behavior. Conclusion: According to the study, the self-care behavior of medication and barriers to exercise were the highest. Barriers to exercise highly influenced self-care behavior. Barriers to diet and exercise were significantly correlated the self-care behavior. Further study or interventions are necessary to decrease barriers in patients with type 2 diabetes.

• 한국농촌간호학회지
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• 제9권2호
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• pp.45-58
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• 2014

Purpose: To determine the knowledge and treatment compliance with hypertension, directions for the aspects of implementation, and related factors to patients with hypertension using Primary Health Cares and Private Clinics Hospitals. Method: General characteristics and High blood pressure-related properties(17 questions), Hypertension knowledge measures(20 questions), and Treatment Compliance(22 questions) were used. Result: 1. The patients of Private Clinics Hospitals had statistically significantly higher drinking habits than Primary Health Care centers. The patients of Private Clinics Hospitals had statistically significantly higher rate of no family history of hypertension than Primary Health Care centers. 2. Primary Health Care centers had statistically significantly higher knowledge of hypertension than Private Clinics Hospitals. Primary Health Care centers had statistically significantly higher treatment compliance than Private Clinics Hospitals. Conclusion: Both Primary Health Care centers and Private Clinics Hospitals are high medication compliance but low lifestyle compliance with hypertension. We need to recognize the importance of lifestyle compliance, to apply proper programs and to provide therapists' aggressive intervention.

• 대한간호학회지
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• 제33권8호
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• pp.1145-1152
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• 2003

Propose. An effective rehabilitation program had been developed for psychiatric patients' self management of medication and symptoms in Korea. The rehabilitation program was designed to allow the patients to understand their illness, cope with their medical regimen, and prevent a relapse by recognizing any of the symptoms when they recur. Methods. The developed program utilizes the self efficacy method reported by Bandura, it includes manuals and videotapes focusing on real life situations, small group discussions, and telephone coaching. This study investigated the effects of this program with respect to various predictable variables in psychiatric rehabilitation. Thirty eight patients were selected for this study, 18 in the experimental program and 20 as controls. Results. The results showed that the subjects who attended this educational program reported significantly more improvement in attitude toward medication compliance (p=0.033), and significantly less relapse warning symptom scores (p=0.000) than the controls. Conclusion. This program may be a useful psychoeducational resource for professionals in the field of clinical practice in psychiatry.

• 성인간호학회지
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• 제20권6호
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• pp.829-838
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• 2008

Purpose: The purpose of this study was to explore the differences of health locus of control and treatment compliance according to general characteristics and severity in acute coronary syndrome(ACS) patients after percutaneous coronary intervention. Methods: This descriptive study was conducted with a convenient sample of 103 ACS patients. The dependent variables were measured by the scales for the Multidimensional Health Locus of Control and the Treatment Compliance. The collected data were analyzed by the Fisher's exact test, Chi-square and t-tests, and ANOVA using the SPSS program. Results: Pre-interventional severity was significantly different between men and women. In terms of internal health locus of control, there was a significant difference according to gender, educational status, economic status, and severity. The level of medication compliance was the lowest among the sub-scales of treatment compliance. Conclusion: These findings suggest that clinical nurses should evaluate the general characteristics and severity of the patients with ACS for providing tailored nursing interventions.

• 한국임상약학회지
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• 제16권2호
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• pp.92-95
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• 2006

Medication counseling improves patients' compliance, which enhances the effectiveness of treatment and reduces the medical cost consequently. Since separation of dispensary from medical practice took place, most patients have had to go to pharmacy after receiving prescription from hospital. The importance of medication counseling in pharmacy thus has been emphasized. To study the present conditions of medication counseling from the pharmacists and the patients satisfaction with them, we conducted a survey with questionnaires. The subjects were 146 outpatients and 55 pharmacies located in Yeongdeungpo-gu. The research showed that 69.9% of the outpatients had received medication counseling and only 35.5% of them were satisfied with it. The main reason for their unsatisfaction was insufficiency of explanation. A number of patients(75.3%) were thinking that medication counseling from the pharmacists is necessary for appropriate administration and optimal efficacy of the medicine. Among 55 pharmacies involved in the research, 17 of them(30.9%) answered that they have been giving patients medication counseling, which were mostly verbally done. Only 8 of them(l4.5%) were providing medication information sheets for some specific drugs. The pharmacists referred to a few problems disturbing optimal medication counseling like these: 1) Lack of time, 2) insufficient information, 3) inappropriate counseling skills. To improve these problems, they hope to get more information about prescription and specific medicines from pharmacy in hospital. If hospital decides to hold the lectures on medication counseling, about 80% of the pharmacists tend to take part in them.

• Journal of Preventive Medicine and Public Health
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• 제40권3호
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• pp.249-258
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• 2007

Objectives : The aims of this study were to estimate the antihypertensive medication adherence in people with a disability and a history of taking antihypertensive medication, and to identify the factors affecting medication adherence. Methods : The National Health Insurance claims data were linked with the National Disability Registry. People with a disability, who received a prescription of antihypertensives, were identified from a total of 85,098 cases. Cumulative medication adherence (CMA) was used as an indicator of medication adherence. A CMA > 80% was defined as appropriate medication adherence. Multiple logistic regression analysis was used to identify the factors affecting medication adherence. Results : The average CMA in a total of 85,098 patients was 79.5%. The appropriate adherence $(CMA{\geq}80%)$ rate was 54.5% and 20.5% of patients had a CMA < 50%. Multiple logistic regression analysis revealed that the probability of appropriate adherence decreased with decreasing number of prescription days per visit, increasing number of providers, the patients' residential area moving from urban to rural areas, and when patients have an internal organ disability, auditory impairment, mobility impairment. Conclusions : The adherence to antihypertensive medication in people with a disability is influenced by various socio-economic, clinical and regional factors. In particular, the disabled who have locomotive and communication disabilities and internal organ impairments have a higher probability of under-adherence to antihypertensive medication adherence in Korea.

• 가정의학회지
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• 제39권6호
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• pp.325-332
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• 2018

Background: Hypertension is a major contributor to the global disease burden of cardiovascular and cerebrovascular disease. The aim of this study was to determine demographic and clinical factors associated with adherence to antihypertensive medication. Methods: From August 2012 to February 2015, we recruited 1,523 Korean patients with hypertension who visited family physicians. The study was conducted in 24 facilities located in urban and metropolitan areas. Of these facilities, two were primary care clinics and 22 were level 2 or 3 hospitals. Adherence was assessed using the pill count method; a cut-off value of 80% was used as the criterion for good adherence. Sociodemographic and lifestyle factors were compared between the adherent and nonadherent groups using the chi-square test for categorical variables and t-test for continuous variables. Binary logistic regression analysis was performed with medication adherence as the outcome variable. Results: Of the 1,523 patients, 1,245 (81.7%) showed good adherence to antihypertensive medication. In the multivariate logistic analysis, age ${\geq}65$ years, exercise, treatment in a metropolitan-located hospital, being on ${\geq}2$ classes of antihypertensive medication and concomitant medication for diabetes, and a family history of hypertension or cardiovascular diseases were associated with good adherence. Patients who had a habit of high salt intake were less adherent to medication. Conclusion: Multiple classes of antihypertensive medications, concomitant medication, and exercise were associated with good adherence to antihypertensive medication, and high salt intake was associated with poor adherence to antihypertensive medication. These factors should be considered to improve hypertension control.