【摘要】 目的 分析老年高血压患者居家治疗期间用药偏差的发生率、偏差类型及影响因素，并探讨居家期间用药偏差对血压的影响。方法 选取2023年11月—2024年4月在株洲市某社区卫生服务中心和某乡镇卫生院建立居民健康档案的老年高血压患者589例为研究对象，采用一般资料调查表、高血压自我管理量表和慢性病经济毒性问卷(financial toxicity in chronic disease scale, FTCDS)及中文版用药偏差评估工具(medication discrepancy tool, MDT)进行调查，了解患者的用药偏差现状，并通过logistic回归分析其影响因素。结果 589例患者居家用药期间用药偏差发生率为58.1%;用药偏差类型有12种，最主要的类型为“漏服”。logistic回归分析结果显示：文化程度、就医便利性、服药数量、共病数量、高血压自我管理得分、经济毒性得分是用药偏差的独立影响因素。与无用药偏差的患者相比，发生用药偏差的老年高血压患者血压值更高，差异有统计学意义(P<0.05)。结论 老年高血压患者居家治疗期间用药偏差发生率较高，基层医务人员应重视老年高血压患者用药偏差的管理工作，制定针对性的干预措施，确保患者用药安全。更多还原

【Abstract】 Objective To analyze the incidence, deviation types, and influencing factors of medication deviations in elderly hypertensive patients during home treatment, and to explore the impact of medication deviations on blood pressure during this period. Methods Elderly hypertensive 589 patients who established resident health records at a community health service center and a rural health clinic in Zhuzhou city from November 2023 to April 2024 were selected as study subjects. A general information questionnaire, hypertension self-management ability scale, financial toxicity in chronic disease scale(FTCDS), and Chinese version of the medication discrepancy tool(MDT) were used to investigate the current status of patients’ medication deviations, and logistic regression analysis was conducted to identify the influencing factors. Results The incidence of medication deviations in 589 patients during home treatment was 58.1%; There are 12 types of medication deviations, The most common type of deviation was "missed doses". The results of logistic regression analysis was showed that educational level, accessibility of medical care, number of medications taken, number of comorbidities, hypertension self-management score, and economic toxicity score were independent influencing factors for medication deviations in elderly hypertensive patients. Compared with patients without medication deviations, elderly hypertensive patients with medication deviations had significantly higher blood pressure values, and the difference was statistically significant(P<0.05). Conclusion The incidence of medication deviations in elderly hypertensive patients during home treatment is relatively high. Primary healthcare workers should pay close attention to the management of medication deviations in elderly hypertensive patients and develop targeted interventions to ensure patient medication safety.更多还原