目的：探討影響門診三高病患對於降血壓藥品順從性的因子。

方法：本研究為回溯性觀察型研究，研究材料取自鳳山院區健保申報資料，指標日期為2008年1-12月。研究對象為指標日期內初次在本院確診為三高病患後使用高血壓相關藥物。初次確診定義為其指標日期溯及一年期間未曾出現過三高診斷碼。由長庚醫療資訊管理部門提供2007～2009年間所有門診的三高病患檔及高血壓病患檔案交叉比對篩選，以降血壓藥品使用天數來換算藥品持有率(medication possession ratio, MPR)，其定義為一個藥品調劑給病患的總天數除以治療的天數，三高診斷確定後第一次使用降血壓藥品為起始日，以起始日加上365天門診就醫紀錄作為計算。

結果：三高病患有明顯增加趨勢，統計分析結果顯示，高血壓藥品2種以上(含)順從性較好；處方尤其31-60天連續處方會明顯增加其服藥順從性。

結論：對於三高疾病之血壓控制較不好的病患，採取調整處方天數或採用合併治療將有利於增加病患服藥順從性。
 

Purpose：To investigate factors that affect antihypertensive medicine adherence for patients with hypertension, diabetes mellitus and hyperlipidemia (TW3H).

Methods：This retrospective observational study design was implemented by using administrative claims data from the Kaohsiung municipal Feng Shan Hospital (index date between January 2008 and December 2008).The study subjects were patients initially diagnosed as TW3H, then used related hypertensive drugs within index date. The primary diagnosis was defined as not having had TW3H diagnostic code within 12 months prior to index date. Medication adherence was assessed by medication possession ratio (MPR), which calculated by days of utilization of anti-hypertensive drugs, is defined as total days of a drug dispensed to a patient divided by the treatment period (day). Then the treatment period is defined as the initial day of use of anti-hypertensive drugs after the date of first diagnoses of TW3H to the end, 365 days after that day.

Results：Statistical analysis results demonstrate that patients’ adherence rate improves as the mean daily numbers of antihypertensive pills reach ≧2. In multiple logistic regression analysis, compliance improves in those whose prescription days last between 31 and 60 days.  

Conclusion: In this study, adjust to a longer prescription day and use a combination of two or more antihypertensive agents may be helpful for increasing patient medication compliance