Regularity of Clinical Visits and Medication Adherence of Patients with Hypertension or Diabetes in Rural Yunnan Province of China
Abstract
:1. Introduction
2. Materials and Method
2.1. Sampling
2.2. Data Collection
2.3. Statistical Analysis
2.4. Ethical Approval
3. Results
3.1. Characteristics of Sample PWHD
3.2. Regularity of Clinical Visits and Medication Adherence
3.3. Health Care Seeking Behaviors at First Experience with Care
3.4. Factors Affecting the Regularity of Clinical Visits and Medication Adherence
3.5. Workloads of Village Clinics in Terms of PWHD Management
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Data Availability Statement
References
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Number of Diseases | Total | Hypertension | Diabetes |
---|---|---|---|
One disease | 272 | 244 | 28 |
Two diseases | 20 | 20 | 20 |
Total | 292 | 264 | 48 |
Variable | Total n1 = 292 | Hypertension n2 = 264 | Diabetes n3 = 48 |
---|---|---|---|
Number (%) | Number (%) | Number (%) | |
1. Gender | |||
Male | 132 (45) | 120 (45) | 22 (46) |
Female | 160 (55) | 144 (55) | 26 (54) |
2. Age | |||
<50 | 39 (13) | 33 (12) | 6 (13) |
50–59 | 77 (27) | 68 (26) | 15 (31) |
60–69 | 103 (35) | 94 (36) | 17 (35) |
≥70 | 73 (25) | 69 (26) | 10 (21) |
3. Education level | |||
Never attended school | 125 (43) | 111 (42) | 24 (50) |
1–6 years study | 123 (42) | 113 (43) | 16 (33) |
7–9 years study | 31 (11) | 27 (10) | 8 (17) |
>9 years study | 13 (4) | 13 (5) | 0 (0) |
4. Self-reported health status | |||
Not good | 162 (56) | 144 (55) | 35 (73) |
Medium | 86 (29) | 78 (29) | 10 (21) |
Good | 44 (15) | 42 (16) | 3 (6) |
5. Poverty-stricken family | |||
Yes | 90 (31) | 81 (31) | 18 (38) |
No | 202 (69) | 183 (69) | 30 (62) |
Variable | Hypertension n1 = 264 | Diabetes n2 = 48 |
---|---|---|
Number (%) | Number (%) | |
1. Level of health facilities selected to buy medicine last time | ||
No treatment or did not take medicine for a while | 71 (27) | 7 (15) |
Village clinic | 58 (22) | 6 (12) |
Township health center | 22 (8) | 7 (15) |
County and upper level of hospitals | 39 (15) | 16 (33) |
Drugstore | 50 (19) | 11 (23) |
Others a | 24 (9) | 1 (2) |
2. Clinical visits regularly in the last three months | ||
Yes | 71 (27) | 10 (21) |
No | 193 (73) | 38 (79) |
3. Medication adherence in the last three months | ||
Yes | 158 (60) | 36 (75) |
No | 106 (40) | 12 (25) |
4. Clinical visits or medication adherence regularly in the last three months | ||
Yes | 161 (61) | 36 (75) |
No | 103 (39) | 12 (25) |
Variable | Hypertension Sample n1 = 264 | Diabetes Sample n2 = 48 |
---|---|---|
Number (%) | Number (%) | |
1. The duration of the chronic disease a | ||
Preceding five years | 167 (63) | 25 (52) |
Five years ago | 64 (24) | 15 (31) |
Ten years ago | 33 (13) | 8 (17) |
2. Source of detection | ||
Visiting physicians after clinical manifestations | 91 (34) | 26 (54) |
Physical examination | 108 (41) | 13 (27) |
Other disease visit | 65 (25) | 9 (19) |
3. Level of health facilities selected to seek medical treatment at first visit | ||
No treatment | 38 (14) | 2 (4) |
Take medicine at the drugstore | 21 (8) | 2 (4) |
Clinical visits b | 205 (78) | 44 (92) |
Village clinic | 63 (24) | 6 (13) |
Township health center | 39 (15) | 13 (27) |
County and upper level of hospitals | 90 (34) | 25 (52) |
Others c | 13 (5) | 0 (0) |
4. Treatment delay at first visit d | ||
Within 1 week | 150 (66) | 31 (65) |
>1 week | 76 (34) | 17 (35) |
5. Number of health provider visits before first diagnosis d | ||
1 time | 207 (92) | 43 (93) |
>1 time | 19 (8) | 3 (7) |
Variable | Clinical Visits or Medication Adherence in the Last Three Months | |||
---|---|---|---|---|
Coef | Adjusted OR | 95% CI | p Value | |
1. Gender | ||||
Male (ref) | 1.00 | |||
Female | 0.33 | 1.39 | 0.74–2.61 | 0.299 |
2. Age | ||||
<50 (ref) | 1.00 | |||
50–59 | 1.10 | 3.02 | 1.20–7.59 | 0.019 |
60–69 | 1.11 | 3.03 | 1.22–7.52 | 0.017 |
≥70 | 1.03 | 2.79 | 1.09–7.16 | 0.032 |
3. Education level | ||||
Never attended school (ref) | 1.00 | |||
1–6 years study | 0.60 | 1.83 | 0.95–3.53 | 0.071 |
7–9 years study | 0.75 | 2.12 | 0.73–6.17 | 0.169 |
>9 years study | 1.41 | 4.09 | 0.87–19.28 | 0.075 |
4. Self-reported health status | ||||
Not good (ref) | 1.00 | |||
Medium | −0.72 | 0.49 | 0.26–0.90 | 0.022 |
Good | −0.69 | 0.50 | 0.22–1.14 | 0.099 |
5. Poverty-stricken family | ||||
Yes (ref) | 1.00 | |||
No | 0.68 | 1.97 | 1.08–3.62 | 0.028 |
6. Clinical visits at first experience with care | ||||
Yes (ref) | 1.00 | |||
No | −1.95 | 0.14 | 0.07–2.90 | <0.001 |
7. The duration of the chronic disease | ||||
Preceding five years (ref) | 1.00 | |||
Five years ago | 0.45 | 1.58 | 0.81–3.08 | 0.184 |
Ten years ago | 0.24 | 1.28 | 0.52–3.12 | 0.593 |
Variable | Mean | SD |
---|---|---|
1. Number of physicians per VC | 2.03 | 0.98 |
2. Number of outpatients per VC in the previous month | 450.63 | 650.91 |
3. Number of villages each VC provided public health services for | 1.03 | 0.46 |
4. Population per VC | 3032.15 | 1602.56 |
5. Number of patients managed per VC a | ||
Hypertension | 179.70 | 125.99 |
Diabetes | 44.51 | 39.14 |
6. Number of new suspected patients that were diagnosed in the last year | ||
Hypertension | 14.58 | 19.65 |
Diabetes | 3.50 | 5.25 |
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Gao, Q.; Peng, L.; Min, W.; Nie, J.; Wang, A.; Shi, Y.; Shi, H.; Teuwen, D.E.; Yi, H. Regularity of Clinical Visits and Medication Adherence of Patients with Hypertension or Diabetes in Rural Yunnan Province of China. Int. J. Environ. Res. Public Health 2020, 17, 9297. https://doi.org/10.3390/ijerph17249297
Gao Q, Peng L, Min W, Nie J, Wang A, Shi Y, Shi H, Teuwen DE, Yi H. Regularity of Clinical Visits and Medication Adherence of Patients with Hypertension or Diabetes in Rural Yunnan Province of China. International Journal of Environmental Research and Public Health. 2020; 17(24):9297. https://doi.org/10.3390/ijerph17249297
Chicago/Turabian StyleGao, Qiufeng, Lanxi Peng, Wenbin Min, Jingchun Nie, Aiqin Wang, Yaojiang Shi, Haonan Shi, Dirk E. Teuwen, and Hongmei Yi. 2020. "Regularity of Clinical Visits and Medication Adherence of Patients with Hypertension or Diabetes in Rural Yunnan Province of China" International Journal of Environmental Research and Public Health 17, no. 24: 9297. https://doi.org/10.3390/ijerph17249297