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Original Articles

Association between Patient Experience and Medication Compliance of Dyslipidemia: Using Korea National Health and Nutrition Examination Survey (2015)
Ho-Hyoun Yim, Hwan-Sik Hwang, Hoon-Ki Park, Kye-Yeung Park, Miso Park
Korean J Fam Med 2021;42(2):116-122.   Published online March 20, 2021
DOI: https://doi.org/10.4082/kjfm.19.0128
Background
This study aimed to examine the relationship between patient experience and medication compliance of patients with dyslipidemia.

Methods
Based on data from the Korea National Health and Nutrition Examination Survey in 2015, the study examined 764 patients treated with dyslipidemia medication. Subjects who responded to the question “Do you currently take medication to lower your blood cholesterol?” with “daily taking” were categorized as the compliant group, and the remaining subjects were classified under the non-compliant group. The patient experience survey included four indicators, in which subjects were divided into groups with a positive and negative patient experience. Data on sociodemographic factors, health-related behaviors, and self-reported comorbid conditions were also collected.

Results
After adjusting the variables, the group with a positive response for the patient experience indicator “doctor spends enough time with the patient during consultation” was 1.89 times more compliant than the group with a negative response (95% confidence interval [CI], 1.03–3.48; P=0.04). For the indicator “doctor provides easy-to-understand explanations,” the group that showed a positive response was 2.74 times more compliant than the group with a negative response (95% CI, 1.39–5.39; P=0.004). For the indicator “doctor involves patients in decisions about care or treatment,” the group that showed a positive response was 2.07 times more compliant than the group with a negative response (95% CI, 1.02–4.22; P=0.04). However, for the indicator “doctor provides the patient a chance to ask questions about treatment,” positive patient experience had no significant association with medication compliance (95% CI, 0.77–2.36; P=0.30).

Conclusion
Building a good doctor-patient relationship with positive patient experiences can result in better outcomes for patient care through high medication compliance.

Citations

Citations to this article as recorded by  
  • Insights into medication adherence among Jordanian patients with dyslipidemia: evaluating health literacy, well-being, and doctor-patient communication
    Muna Barakat, Samar Thiab, Shaymaa B. Abdulrazzaq, Marah Al-Jamal, Fotoh AlHariri, Rakan Bassam Ammari, Sara Mansour, Sami El Khatib, Souheil Hallit, Basile Hosseini, Diana Malaeb, Hassan Hosseini
    Journal of Pharmaceutical Policy and Practice.2024;[Epub]     CrossRef
  • 5,356 View
  • 108 Download
  • 1 Web of Science
  • 1 Crossref
Uncontrolled Blood Pressure in Hypertensive Patients with High Medication Adherence: A Korean Nationwide Population-Based Study
Jiwon Kwon, Chi-Yeon Lim, Minkyeong Kim
Korean J Fam Med 2020;41(1):28-37.   Published online January 8, 2020
DOI: https://doi.org/10.4082/kjfm.19.0051
Background
Uncontrolled blood pressure (BP) is relatively common despite treatment with antihypertensive medication. This study aimed to investigate factors associated with uncontrolled systolic BP (SBP) and diastolic BP (DBP) separately in hypertensive patients with high medication adherence in Korea.
Methods
This population-based cross-sectional study included 3,236 participants in the Korea National Health and Nutrition Examination Survey from 2013 to 2015. Hypertensive patients with high medication adherence were defined when they stated that they were taking antihypertensive medication daily. “Uncontrolled SBP and DBP” were defined as SBP ≥140 mm Hg and DBP ≥90 mm Hg, respectively. Data were analyzed using logistic regression to determine the association between uncontrolled SBP or DBP and various factors.
Results
The prevalence of uncontrolled SBP and uncontrolled DBP was 23.3%, and 9.0%, respectively. In multivariate analysis, uncontrolled SBP was positively associated with older age, female sex, blue-collar occupation or no work (vs. white-collar), presence of a spouse, short sleep duration, frequent heavy alcohol drinking, longer hypertension duration, diabetes, stroke, and missing antihypertensive medication on the examination day, but negatively associated with high stress. Uncontrolled DBP was positively associated with frequent heavy alcohol drinking, but negatively associated with older age, blue-collar occupation or no work (vs. white-collar), and diabetes.
Conclusion
After excluding low medication adherence, we identified various factors associated with uncontrolled SBP or DBP in Korean adults with treated hypertension. There were differences between factors associated with uncontrolled SBP or DBP. Separate analysis of SBP and DBP may help understand the factors involved in BP control.

Citations

Citations to this article as recorded by  
  • Factor associated with and risk of cardiovascular disease in people with uncontrolled hypertension
    Sara Ringwald-de Meyer, Roxane de La Harpe, Peter Vollenweider, Pedro Marques-Vidal, Julien Vaucher
    Scientific Reports.2025;[Epub]     CrossRef
  • Prevalence, awareness, treatment and control of arterial hypertension depending on regional characteristics in Russia: results of the ESSE-RF study 2012-2022 — evidence of COVID-19 impact?
    S. A. Maksimov, S. A. Shalnova, Yu. A. Balanova, A. E. Imaeva, V. A. Kutsenko, M. B. Kotova, G. A. Muromtseva, S. E. Evstifeeva, A. V. Kapustina, N. S. Karamnova, O. B. Shvabskaya, T. V. Repkina, T. O. Gonoshilova, A. V. Kudryavtsev, N. I. Belova, L. L. S
    Rational Pharmacotherapy in Cardiology.2025; 21(2): 108.     CrossRef
  • Exploring the Influence of a Single Bout of Tahajjud Prayer on Acute Blood Pressure Response in Normotensive Young Adult Males with Varied Regularity of Tahajjud Practice
    Yusni Yusni, Hanifah Yusuf, Mustanir Yahya
    Islamic Guidance and Counseling Journal.2023;[Epub]     CrossRef
  • Adherence to Self-Care among Patients with Hypertension in Ethiopia: A Systematic Review and Meta-Analysis
    Afework Edmealem, Sewunet Ademe, Sisay Gedamu, Tomohiro Katsuya
    International Journal of Hypertension.2022; 2022: 1.     CrossRef
  • Medication Adherence and Effective Management of Hypertension
    Seung-Won Oh
    Korean Journal of Family Medicine.2021; 42(2): 89.     CrossRef
  • A Modified Recommended Food Score Is Inversely Associated with High Blood Pressure in Korean Adults
    Kyuyoung Han, Yoon Jung Yang, Hyesook Kim, Oran Kwon
    Nutrients.2020; 12(11): 3479.     CrossRef
  • 7,616 View
  • 144 Download
  • 5 Web of Science
  • 6 Crossref
Factors Associated with Compliance with the Recommended Frequency of Postnatal Care Services in Four Rural Districts of Tigray Region, North Ethiopia
Teklehaymanot Huluf Abraha, Berhe Beyene Gebrezgiabher, Berihu Gidey Aregawi, Desta Siyoum Belay, Lidiya Tsegay Tikue, Ermyas Brhane Reda
Korean J Fam Med 2019;40(5):329-334.   Published online January 14, 2019
DOI: https://doi.org/10.4082/kjfm.18.0023
Background
The postpartum period has been advocated as a way to improve the survival of mothers and newborns. However, the status of the recommended number of postnatal care (PNC) services has not been well studied. The purpose of this study was to assess the level of full PNC visits and factors associated with it among mothers.
Methods
A community-based cross-sectional study was performed among 1,109 women from March to April 29, 2017. Data were collected via face-to-face interviews, recorded using EPI INFO ver. 7.0 (Centers for Disease Control and Prevention, Atlanta, GA, USA) and analyzed by STATA ver. 12.0 (Stata Corp., College Station, TX, USA). Multivariate logistic regression was applied to assess the predictors of the recommended frequency of PNC services. Adjusted odds ratios (aORs) at 95% confidence interval (CIs) were performed. P-values <0.05 were declared statistically significant.
Results
Status of compliance with the use of full PNC services was found to be 16.1%. Women who had antenatal care follow-up (aOR, 5.60; 95% CI, 2.50 to 12.55) and women who delivered at health institutions (aOR, 3.66; 95% CI, 1.74 to 7.70) were more likely to have full PNC visits. Proximity of women to health facilities was found to lower the odds of complete PNC visits (aOR, 0.24; 95% CI, 0.10 to 0.56). Moreover, district of residence remains a predictor of service use.
Conclusion
The percentage of women with full PNC visits was found to be low. Therefore, to achieve the recommended frequency of PNC in the study area, the results of this study suggest a need to strengthen the uptake of ANC and institutional delivery services.

Citations

Citations to this article as recorded by  
  • Spatial patterns and determinants of low utilization of delivery care service and postnatal check-up within 2 months following birth in Ethiopia: Bivariate analysis
    Shegaw Mamaru Awoke, Frezer Tilahun Getaneh, Muluwerk Ayele Derebe, Gulzhanat Aimagambetova
    PLOS ONE.2024; 19(1): e0297038.     CrossRef
  • Exploring the Influence of Sociodemographic Characteristics on the Utilization of Maternal Health Services: A Study on Community Health Centers Setting in Province of Jambi, Indonesia
    Herwansyah Herwansyah, Katarzyna Czabanowska, Stavroula Kalaitzi, Peter Schröder-Bäck
    International Journal of Environmental Research and Public Health.2022; 19(14): 8459.     CrossRef
  • Spatial distribution and determinants of newbornsnot receiving postnatal check-up withintwodays after birth in Ethiopia: a spatial and multilevel analysis of EDHS 2016
    Destaye Guadie Kassie, Nega Tezera Assimamaw, Tadesse Tarik Tamir, Tewodros Getaneh Alemu, Masresha Asmare Techane, Chalachew Adugna Wubneh, Getaneh Mulualem Belay, Amare Wondim Ewuntie, Bewuketu Terefe, Adiss Bilal Muhye, Bethelihem Tigabu Tarekegn, Moha
    BMC Pediatrics.2022;[Epub]     CrossRef
  • Association between health insurance enrolment and maternal health care service utilization among women in Ethiopia
    Abdu Seid, Mohammed Ahmed
    BMC Public Health.2021;[Epub]     CrossRef
  • Determinants of postnatal checkup for newborns in Ethiopia: Further analysis of 2016 Ethiopia demographic and health survey
    Abdu Seid, Mohammed Ahmed
    BMC Pregnancy and Childbirth.2020;[Epub]     CrossRef
  • 7,142 View
  • 113 Download
  • 6 Web of Science
  • 5 Crossref
Factors Affecting Adherence to Antihypertensive Medication
Hyo Yoon Choi, Im Jung Oh, Jung Ah Lee, Jisun Lim, Young Sik Kim, Tae-Hee Jeon, Yoo-Seock Cheong, Dae-Hyun Kim, Moon-Chan Kim, Sang Yeoup Lee
Korean J Fam Med 2018;39(6):325-332.   Published online November 2, 2018
DOI: https://doi.org/10.4082/kjfm.17.0041
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 ≥65 years, exercise, treatment in a metropolitan-located hospital, being on ≥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.

Citations

Citations to this article as recorded by  
  • Prevalence of antihypertensive medication adherence and associated factors in India: A systematic review and meta-analysis
    B. Pal, A. Dutta, V. Chaudhary, S. Kumari, S. Meenakshi, K. Murti
    Hipertensión y Riesgo Vascular.2025; 42(3): 156.     CrossRef
  • Analysis of Adherence Status and Influencing Factors Among Middle‐Aged and Elderly Hypertension Patients in Rural Areas of Northeast China
    Xinyuan Lu, Jiwei Wang, Sikun Chen, Lin Lv, Jinming Yu, Peng Geng
    International Journal of Hypertension.2025;[Epub]     CrossRef
  • Adherence to hypertension management at a rural hospital in Limpopo: A cross-sectional study
    Murendeni F. Sikhau, Mbuyisa J. Makhubu, Gert J.O. Marincowitz, Clara Marincowitz
    South African Family Practice.2025;[Epub]     CrossRef
  • Development and Validation of Predictive Models for Non-Adherence to Antihypertensive Medication
    Cristian Daniel Marineci, Andrei Valeanu, Cornel Chiriță, Simona Negreș, Claudiu Stoicescu, Valentin Chioncel
    Medicina.2025; 61(7): 1313.     CrossRef
  • Self-care practice and associated factors among hypertensive patients in Ethiopia: Umbrella review of systematic review and meta-analysis studies
    Sefineh Fenta Feleke, Anteneh Mengist Dessie, Atitegeb Abera Kidie, Muluemebet Kassa, Tesfaye Engdaw Habtie, Natnael Amare Tesfa, Zenebe Daniel Getachew, Tadele Emagneneh, Wagaw Abebe
    International Journal of Nursing Studies Advances.2025; 9: 100433.     CrossRef
  • Frequency of missed doses and its effects on the regulation of glucose levels in patients with type 2 diabetes: A retrospective analysis
    Megumi Shiomi, Tesshu Takada, Katsuya Otori, Kiyoshi Shibuya
    Medicine.2024; 103(15): e37711.     CrossRef
  • Non-adherence to appointment follow-up and its associated factors among hypertensive patients in follow-up clinics in South Gondar hospitals
    Gebrie kassaw Yirga, Getu Sisay Mekonen, Endalk Getasew Hiruy, Kirubel Shiferaw, Berihun Bantie
    Scientific Reports.2024;[Epub]     CrossRef
  • Factors associated with suboptimal adherence to antihypertensive medication: Cross-sectional study using nationally representative databases
    Sangyong Jo, Taegyu Um, Jihye Shin, Dongchan Lee, Kyungil Park, Minkook Son
    Heliyon.2024; 10(19): e38531.     CrossRef
  • ОСОБЛИВОСТІ ПАЦІЄНТ-ОРІЄНТОВАНОГО СПІЛКУВАННЯ ІЗ ПАЦІЄНТОМ З АРТЕРІАЛЬНОЮ ГІПЕРТЕНЗІЄЮ
    Д. О. Лагода
    Здобутки клінічної і експериментальної медицини.2024; (4): 39.     CrossRef
  • Blood Pressure Profile and Factors Affecting Medication Adherence in Older Persons with Hypertension in Two Care Centers
    Chinonyerem O. Iheanacho, Agbaje Akeem Babatunde, Uchenna I. H. Eze
    Ageing International.2023; 48(3): 729.     CrossRef
  • Opportunities of Amlodipine as a Potential Candidate in the Evaluation of Drug Compliance during Antihypertensive Therapy
    Dmitrijs Kustovs, Inga Urtāne, Eduards Sevostjanovs, Eva Moreino, Kārlis Trušinskis
    Medicina.2023; 59(2): 340.     CrossRef
  • Impact of health literacy and social support on medication adherence in patients with hypertension: a cross-sectional community-based study
    Aizhen Guo, Hua Jin, Jianbo Mao, Weihong Zhu, Ye Zhou, Xuhua Ge, Dehua Yu
    BMC Cardiovascular Disorders.2023;[Epub]     CrossRef
  • Effectiveness of the Combination of Enalapril and Nifedipine for the Treatment of Hypertension versus Empirical Treatment in Primary Care Patients
    Humberto Badillo-Alonso, Marisol Martínez-Alanis, Ramiro Sánchez-Huesca, Abel Lerma, Claudia Lerma
    Journal of Cardiovascular Development and Disease.2023; 10(6): 243.     CrossRef
  • Factors Influencing Medication Adherence in Elderly Patients with Hypertension: A Single Center Study in Western China
    Qiuyu Pan, Cheng Zhang, Lansicheng Yao, Chenyao Mai, Jinpeng Zhang, Zhitong Zhang, Jun Hu
    Patient Preference and Adherence.2023; Volume 17: 1679.     CrossRef
  • The Development and Validation of the “Hippocratic Hypertension Self-Care Scale”
    Hero Brokalaki, Anastasia A. Chatziefstratiou, Nikolaos V. Fotos, Konstantinos Giakoumidakis, Evaggelos Chatzistamatiou
    Healthcare.2023; 11(18): 2579.     CrossRef
  • Adherence Behaviors and Related Factors Among Elderly Hypertensive Patients in China: Evidence from the China Health and Retirement Longitudinal Study
    Fengyu Liu, Huajing Chang, Xiaojun Liu
    Patient Preference and Adherence.2023; Volume 17: 3539.     CrossRef
  • Predictors of non-adherence to antihypertensive medications: A cross-sectional study from a regional hospital in Afghanistan
    Muhammad Haroon Stanikzai, Mohammad Hashim Wafa, Essa Tawfiq, Massoma Jafari, Cua Ngoc Le, Abdul Wahed Wasiq, Bilal Ahmad Rahimi, Ahmad Haroon Baray, Temesgen Anjulo Ageru, Charuai Suwanbamrung, Kahsu Gebrekidan
    PLOS ONE.2023; 18(12): e0295246.     CrossRef
  • The Indian REgistry on Current Patient PrOfiles and TReatment TrenDs in Hypertension (RECORD): Final Outcomes of the Real-world Observational Study
    Girish C Rajadhyaksha, Himanshu Reddy, Amresh K Singh, Abraham Oomman, Srilakshmi M Adhyapak, Mayur Jadhav, Sachin Suryawanshi, Rujuta Gadkari, Sumit Bhushan, Prashant Mishra, Hanmant Barkate
    Journal of the Association of Physicians of India.2023; 71(11): 43.     CrossRef
  • Burden of hypertension in Ghana – Analysis of awareness and screening campaign in the Ashanti Region of Ghana
    Elliot Koranteng Tannor, Obed Ofori Nyarko, Yaw Adu-Boakye, Saabea Owusu Konadu, Gilda Opoku, Frank Ankobea-Kokroe, Mercy Opare Addo, Evans Xorse Amuzu, Gilgal Justice Ansah, Kate Appiah-Boateng, Daniel Ansong
    JRSM Cardiovascular Disease.2022;[Epub]     CrossRef
  • Antihypertensive medications adherence and associated uncontrolled blood pressure among hypertensive patients in Ethiopia: Systematic review and meta-analysis
    Melaku Desta, Desalegn Yibeltal, Peter Memiah, Temesgen Ayenew, Henok Mulugeta, Mihretie Gedefaw, Bekalu Bewket Kidanie, Molla Yigzaw Birhanu, Zenaw Tessema, Belayneh Mengist, Muluneh Alene, Muluye Molla Simieneh, Atsede Alle Ewunetie, Wondimeneh Shibabaw
    International Journal of Africa Nursing Sciences.2022; 16: 100404.     CrossRef
  • Association of adherence measured by self-reported pill count with achieved blood pressure level in hypertension patients: a cross-sectional study
    Iin Ernawati, Eziah Ika Lubada, Ria Lusiyani, Rahmad Aji Prasetya
    Clinical Hypertension.2022;[Epub]     CrossRef
  • Urban-Rural Difference in Treatment Adherence of Chinese Hypertensive Patients
    Jingjing Pan, Haizhen Yu, Bin Hu, Qiongge Li
    Patient Preference and Adherence.2022; Volume 16: 2125.     CrossRef
  • Prevalence of Hypertension in Ghana: Analysis of an Awareness and Screening Campaign in 2019
    Elliot Koranteng Tannor, Obed Ofori Nyarko, Yaw Adu-Boakye, Saabea Owusu Konadu, Gilda Opoku, Frank Ankobea-Kokroe, Mercy Opare-Addo, Lambert Tetteh Appiah, Evans Xorse Amuzu, Gilgal Justice Ansah, Kate Appiah-Boateng, Emmanuel Ofori, Daniel Ansong
    Clinical Medicine Insights: Cardiology.2022;[Epub]     CrossRef
  • Global Burden, Regional Differences, Trends, and Health Consequences of Medication Nonadherence for Hypertension During 2010 to 2020: A Meta‐Analysis Involving 27 Million Patients
    Eric K. P. Lee, Paul Poon, Benjamin H. K. Yip, Yacong Bo, Meng‐Ting Zhu, Chun‐Pong Yu, Alfonse C. H. Ngai, Martin C. S. Wong, Samuel Y. S. Wong
    Journal of the American Heart Association.2022;[Epub]     CrossRef
  • Assessment of Patients’ Views on Drug Benefits and Risks: An Interview Study with Cardiovascular Patients
    Ines Wakob, Ina Wintsche, Annett Frisch, Yvonne Remane, Ulrich Laufs, Thilo Bertsche, Susanne Schiek, Yigit Canga
    International Journal of Clinical Practice.2022;[Epub]     CrossRef
  • Determinants of Adherence to Antihypertensives Among Elderly: A Multifactorial Concern
    Melita Sheilini, H Manjunatha Hande, Elsa Sanatombi Devi, Asha Kamath, Baby S Nayak, Donald E Morisky, Anice George
    Patient Preference and Adherence.2022; Volume 16: 3185.     CrossRef
  • Factors related to treatment adherence among hypertensive patients: A cross-sectional study in primary healthcare centers in Taif city
    Mohammed A. Alsofyani, Adel O. Aloufi, Nada S. Al-Qhtani, Sarah O. Bamansour, Raghad S. Almathkori
    Journal of Family and Community Medicine.2022; 29(3): 181.     CrossRef
  • Determining the Prevalence of and the Factors Associated with Antihypertensive Medication Non-Adherence in the Gaza Strip
    Khalid Khadoura, Elham Shakibazadeh, Mohammad Ali Mansournia, Yousef Aljeesh, Akbar Fotouhi
    Korean Journal of Family Medicine.2021; 42(2): 150.     CrossRef
  • Prevalence of non-adherence to antihypertensive medication in Asia: a systematic review and meta-analysis
    Sajid Mahmood, Zahraa Jalal, Muhammad Abdul Hadi, Tahir Mehmood Khan, M. Sayeed Haque, Kifayat Ullah Shah
    International Journal of Clinical Pharmacy.2021; 43(3): 486.     CrossRef
  • Adherence to Antihypertensive Medication and Incident Cardiovascular Events in Young Adults With Hypertension
    Hokyou Lee, Yuichiro Yano, So Mi Jemma Cho, Ji Eun Heo, Dong-Wook Kim, Sungha Park, Donald M. Lloyd-Jones, Hyeon Chang Kim
    Hypertension.2021; 77(4): 1341.     CrossRef
  • Medication Adherence and Effective Management of Hypertension
    Seung-Won Oh
    Korean Journal of Family Medicine.2021; 42(2): 89.     CrossRef
  • Self-Care Practice and Associated Factors among Hypertensive Patients in Ethiopia: A Systematic Review and Meta-Analysis
    Adam Wondmieneh, Getnet Gedefaw, Addisu Getie, Asmamaw Demis, Kai Hu
    International Journal of Hypertension.2021; 2021: 1.     CrossRef
  • Effects of morbidity on smoking cessation: a national smoking cessation program
    Young-Gyun Seo, Min-Woo Jo, Yu-Jin Paek, Jaekyung Choi
    Addiction Science & Clinical Practice.2021;[Epub]     CrossRef
  • Behavioral Factors Associated with Medication Nonadherence in Patients with Hypertension
    Shu-Mei Chang, I-Cheng Lu, Yi-Chun Chen, Chin-Feng Hsuan, Yin-Jin Lin, Hung-Yi Chuang
    International Journal of Environmental Research and Public Health.2021; 18(18): 9614.     CrossRef
  • Patient adherence to antihypertensive medications in upper Egypt: a cross-sectional study
    Ahmed Hussein, Mohammad Shafiq Awad, Hossam Eldin M. Mahmoud
    The Egyptian Heart Journal.2020;[Epub]     CrossRef
  • Factors associated with nonadherence to antihypertensive medication among middle-aged adults with hypertension: findings from the Taiwan National Health Interview Survey
    Chia-Pei Chou, Chun-Yu Chen, Kun-Siang Huang, Shih-Chun Lin, Chih-Fang Huang, Malcolm Koo
    Journal of International Medical Research.2020;[Epub]     CrossRef
  • Impact of satisfaction with physician–patient communication on self-care and adherence in patients with hypertension: cross-sectional study
    Natalia Świątoniowska-Lonc, Jacek Polański, Wojciech Tański, Beata Jankowska-Polańska
    BMC Health Services Research.2020;[Epub]     CrossRef
  • Mediating Effect of Self-Efficacy on the Relationship Between Medication Literacy and Medication Adherence Among Patients With Hypertension
    Zhiying Shen, Shuangjiao Shi, Siqing Ding, Zhuqing Zhong
    Frontiers in Pharmacology.2020;[Epub]     CrossRef
  • Influence of socio-demographic factors and length of disease on adherence of patients with arterial hypertension
    Marijana Jandrić-Kočič, Snežana Knežević
    Timocki medicinski glasnik.2020; 45(4): 140.     CrossRef
  • Baixo Letramento em Saúde: uma realidade brasileira
    Josué Da Silva Brito, Christiano Tadeu Sanches Mattos Kilesse, Priscilla Itatianny De Oliveira Silva
    HU Revista.2020; 46: 1.     CrossRef
  • Association of Total Medication Burden With Intensive and Standard Blood Pressure Control and Clinical Outcomes: A Secondary Analysis of SPRINT
    Catherine G. Derington, Tyler H. Gums, Adam P. Bress, Jennifer S. Herrick, Tom H. Greene, Andrew E. Moran, William S. Weintraub, Ian M. Kronish, Donald E. Morisky, Katy E. Trinkley, Joseph J. Saseen, Kristi Reynolds, Jeffrey T. Bates, Dan R. Berlowitz, Ta
    Hypertension.2019; 74(2): 267.     CrossRef
  • Association Between Medication Literacy and Medication Adherence Among Patients With Hypertension
    Shuangjiao Shi, Zhiying Shen, Yinglong Duan, Siqing Ding, Zhuqing Zhong
    Frontiers in Pharmacology.2019;[Epub]     CrossRef
  • Assessment of adherence to drug treatment and affecting factors among hypertensive patients
    Burkay YAKAR, Asli AZAKOGLU KARACA, Erhan ONALAN
    Family Practice and Palliative Care.2019; 4(3): 89.     CrossRef
  • Medication Adherence in Korean Hypertensive Patients
    Young Gyu Cho
    Korean Journal of Family Medicine.2018; 39(6): 323.     CrossRef
  • 14,238 View
  • 216 Download
  • 42 Web of Science
  • 44 Crossref
Factors of Compliance in Patients with Hypercholesterolemia Using Rosuvastatin in Primary Care
Hye Young Kim, Jung Ah Lee, Young Sik Kim, Sung Sunwoo, Han Jin Oh, Chang Sup Kim, Keunsang Yum, Changjin Choi, Yoo Seock Jeong, Sang-Wook Song, Dae Hyun Kim, Young Sung Kim
Korean J Fam Med 2012;33(5):253-261.   Published online September 27, 2012
DOI: https://doi.org/10.4082/kjfm.2012.33.5.253
Background

In order to evaluate the factors of compliance with a lipid lowering therapy, a prospective observational study of patients with hypercholesterolemia using rosuvastatin was carried out.

Methods

A total of 2,607 patients who were newly prescribed rosuvastatin were enrolled from 32 family physicians in Korea from March 2009 to December 2009. Of them, 301 patients were excluded due to incomplete data or follow-up compliance data. The patients were regularly observed to ascertain the compliance associated with rosuvastatin at intervals of 12 and 24 weeks. We collected risk factors for the compliance using a structured questionnaire. The criteria for evaluating compliance are to measure clinic attendance, to assess the continuity of therapy, and to calculate the percentage of doses taken.

Results

Among a total of 2,306 patients, the degree of compliance was 54.1%. According to logistic regression analysis, the factors for compliance with the lipid lowering drug included old age (odds ratio [OR], 2.68; 95% confidence interval [CI], 2.09 to 3.45), frequent exercise (OR, 1.76; 95% CI, 1.43 to 2.18), previous statin therapy (OR, 4.02; 95% CI, 3.22 to 5.01), hypertension (OR, 1.80; 95% CI, 1.48 to 2.19), diabetes mellitus (OR, 2.20; 95% CI, 1.69 to 2.87), concomitant medication (OR, 2.28; 95% CI, 1.88 to 2.77), and high coronary heart disease (CHD) risk category (OR, 1.82; 95% CI, 1.39 to 2.38). The compliance decreased with high low density lipoprotein cholesterol levels (OR, 0.20; 95% CI, 0.16 to 0.26).

Conclusion

The compliance of patients using rosuvastatin was 54.1% in primary care. The factors related to higher compliance were old age, regular exercise, previous statin therapy, concomitant medication, presence of hypertension or diabetes, and higher CHD risk level.

Citations

Citations to this article as recorded by  
  • Factors Related to Suboptimal Adherence to Dyslipidemia Medication: An Exploration Using Nationally Representative Databases
    Jihye Shin, Taegyu Um, Sangyong Jo, Minkook Son
    Journal of Lipid and Atherosclerosis.2025; 14(3): 312.     CrossRef
  • Patient-related characteristics associated with non-persistence with statin therapy in elderly patients following an ischemic stroke
    Martin Wawruch, Dusan Zatko, Gejza Wimmer, Jan Luha, Vasil Hricak, Jan Murin, Peter Kukumberg, Tomas Tesar, Adam Hloska, Rashmi Shah
    Pharmacoepidemiology and Drug Safety.2017; 26(2): 201.     CrossRef
  • Improving Medication Adherence in Coronary Heart Disease
    Leah L. Zullig, Katherine Ramos, Hayden B. Bosworth
    Current Cardiology Reports.2017;[Epub]     CrossRef
  • Risk of cardiovascular disease? A qualitative study of risk interpretation among patients with high cholesterol
    Pia Kirkegaard, Adrian Edwards, Mette Bech Risør, Janus Laust Thomsen
    BMC Family Practice.2013;[Epub]     CrossRef
  • Association Between Statin Adherence and Cholesterol Level Reduction from Baseline in a Veteran Population
    Rashid Kazerooni, Jonathan H. Watanabe, Mark Bounthavong
    Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy.2013; 33(10): 1044.     CrossRef
  • Achieving recommended low density lipoprotein cholesterol goals and the factors associated with target achievement of hypercholesterolemia patients with rosuvastatin in primary care
    Jung Ah Lee, Sung Sunwoo, Young Sik Kim, Han Jin Oh, Hee-Cheol Kang, Kyung-Chae Park, Dong Hyuk Sin, Sang Yeoup Lee, Yun Jun Yang, Byung Yeon Yu, Chul-Min Kim
    Current Medical Research and Opinion.2013; 29(7): 751.     CrossRef
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Degree of Compliance with Polypharmacy and Its Influential Factors in Rural Elderly Patients with Chronic Diseases in South Korea.
Mee Ok Kim, Jong Hee Kim, Ji Eun Kim, Bo Ram Park, Joong Won Lee, Hae Goo Park, Hyun Jin Son, Kee Weon Shin, Dae Gyun Kim
J Korean Acad Fam Med 2008;29(8):604-611.   Published online August 10, 2008
Background
This study was to verify the necessity of a control program developed to improve compliance, by conducting a research on the status of medication compliance in the elderly with chronic diseases in rural area and analyzing the related variables. Methods: The organized questionnaire and pill-count were used to collect information on personal details, physical status, drugs taken in the elderly over 65 years old suffering from more than two chronic diseases in one rural area. Results: The mean age of the subjects was 73.13±6.36 (65∼93), and the number of the subjects in compliance group was 60 (77.9%) and the accuracy of self-report which was identified by pill-count was 0.86. Polypharmacy and visiting several clinics were the main factors that decided a low- degree of compliance, with OR of 5.92 (95% CI 1.11∼31.44, P=0.037), and 4.25 (95% CI 1.03∼17.53, P=0.045), respectively. Conclusion: Systematic efforts are necessary and plans must be established without delay to increase compliance in the elderly in the rural, expansively to manage chronic diseases in stay-at-home elders. (J Korean Acad Fam Med 2008;29:604-611)
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The Barriers for Screening Test of Hepatocellular Carcinoma of Hepatitis B Surface Antigen Positive Patients.
Seung Min Oh, Yoon Jung Chang, Dong Ju Lee, Yu Il Kim, Ju Yung Kim, Bong Yul Huh
J Korean Acad Fam Med 2005;26(2):81-87.   Published online February 10, 2005
Background
: The optimal screening tools for hepatocellular carcinoma are regular tests of alpha fetoprotein (aFP) and liver ultrasonography every 6 months in high risk group. To implement successful long-term project for reducing cancer-mortality, it is essential to know the reasons for non-compliance among the high risk group.

Methods : A telephone survey was done among the hepatitis B surface antigen positive patient group who had not received a follow-up test of aFP and liver ultrasonography. This group was selected among the patients who had received health examinations from January, 2002 to December, 2002 at a university hospital center for health promotion, and the reasons for non-compliance were inquired.

Results : There were no statistical differences in educational level, economic status, age, and sex between the patient group who had taken appropriate follow-up tests and the group who had not. But there were statistically significant differences in the admission history and transfusion history between the two groups. The reasons for non-compliance were as follows: 1. ignorance to the significance of follow-up examination (41.7%), 2. lack of time (27.8%), 3. no specific signs of cancer (22.2%), 4. high costs (5.6%), and 5. fear of discovering serious disease.

Conclusion : It is important to have patients educated on the significance of screening and early diagnosis of hepatocellular carcinoma.
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Factors Related to the Compliance of Hormone Replacement Therapy for Menopausal Women.
Kyeong Ho Park, Eun Suk Jun, Hwansik Hwang, Hoonki Park, Jung Kwon Lee
J Korean Acad Fam Med 2003;24(4):353-359.   Published online April 10, 2003
Background
: Hormone replacement therapy (HRT) is the most effective treatment for climacteric symptoms. It also has definitive role in reducing or preventing the risk of osteoporosis. However, compliance with HRT is very poor. This study was conducted to know the compliance of hormone replacement therapy and investigate the determining factors for compliance.

Methods : Review of charts and telephone questionnaires were completed among 107 women who had received HRT in a family medicine clinic at a university hospital. Compliance was determined by the medication availability ratio (MAR): (HRT treated days)/(total number of observed days). An individual with MAR less than 0.75 was considered as partial compliance, and more than 0.75 was considered as complete compliance group.

Results : The average age of 107 subjects was 57.4 years. Among the 107 study subjects, 59 persons (55.1%) were compliant with HRT. Mean observation period was 17.6 months. The compliance with HRT was 60.9%, 55.1%, 49.6% at 12, 24, 36 months, respectively. The compliance was higher in high-perception group compared to low- perception group (P=0.01). Education level, presence of osteoporosis, hysterectomised state, difference in doctor and past fracture history were not associated with compliance. The reasons for starting HRT were physician's recommendation, osteoporosis prevention, treatment of menopausal symptoms, and influence of mass media, in descending order.

Conclusion : The compliance with HRT was 61% at one- year treatment and 50% at three-year teatment period. Positive attitude for HRT was related to higher compliance with HRT. Patient education on HRT is essential for successful compliance of HRT.
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The effect of telephone call reminder on non-compliant patients in outpatient clinic.
Yoo Seock Cheong
J Korean Acad Fam Med 2002;23(4):458-465.   Published online April 1, 2002
Background
: No-show is a major obstacle for proper management in outpatient clinic. This study was performed to evaluate the effectiveness of a reminding telephone call on the compliance after no-show patients in family practice.

Methods : A nurse in family practice called to 590 non-compliant patients who did not visit on the appointment day within 80 days. A single telephone call attempt was directed primarily to the patient or family members for them to make another appointment. The outcome measure was an increased attendance rate within 3 months after telephone calling.

Results : The completed telephone contacted group (N=242) and failed group (N=348) were well balanced for all study variables except age. The attendance rate of 60.7% in the completed group, regardless of who was contacted by telephone, was 40.7% greater than 23.0% attendance rate in the failed group. In the univariate analysis, attendance for patients who lived near the clinic (within 1 hour) was better (45.3%) than that for any other group (P=.02). In the logistic regression analysis, only the telephone call reminder was an independent predictor of attendance (Adjusted OR=5.03, P<.001).

Conclusion : Telephone reminder is a very effective method of increasing attendance in a hospital-based family clinic. The reminder is a consistenly effective intervention whether the message is delivered to the patient or the family member.
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Hepatitis B vaccination completion rate between 0, 1, 2 month and 0, 1, 6 month schedule.
Nak Jin Sung, Ki Heum Park
J Korean Acad Fam Med 2001;22(1):52-58.   Published online January 1, 2001
Background
: Hepatitis B is an important disease in South Korea because the prevalence is high. There are two officially-granted hepatitis B vaccination schedules; 0, 1, 2-month schedule (not, 0, 1, 2, 12-month schedule) and 0, 1, 6-month schedule. This study was performed to compare vaccination completion rate between the two schedules.

Methods : The study subjects were all subjects who came to the City Medical Center to receive their first hepatitis vaccination dose from March to September, 1998. On odd-numbered day, 0, 1, 2-month schedule was delivered and on even-numbered day 0, 1, 6-month schedule was deliv-ered. On the first visit, the data about general characteristics were collected via self-administered questionnaire. Whether three vaccination doses were all received or not was ascertained by vaccination registration book. The subjects whose vaccination completion could not be ascertained by the book were called by telephone. The data were analyzed by Excel and SPSS-PC.

Results : Total collected cases were 822. Among them, 99 cases were excluded from analysis due to reasonable incompletion (11), incorrect inclusion (9) and impossible confirmation (79), which left 723 cases. General characteristics between two groups were not different except the existence of intrafamilial hepatitis carrier. The hepatitis B vaccination completion rate was higher in 0, 1, 2 -month schedule (85.4%) than in 0, 1, 6-month schedule (76.1%) only in the cases without intrafamilial hepatitis B carrier member.

Conclusion : The completion rate of heatitis B vaccination was higher in 0, 1, 2-month schedule than 0, 1, 6-month schedule in the cases without intrafamilial hepatitis B carrier member.
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Controlled Clinical Trial

The effectiveness of a letter reminder on the compliance with periodic follow-up examination in chronic HBsAg-positive patients.
Cheol Hoon Choi, Yun Mi Song, Joo Seob Oh, Jai Jun Byeon
J Korean Acad Fam Med 2000;21(9):1188-1198.   Published online September 1, 2000
Background
: For Chronic HBsAg-positive patients are a well-known high risk group of primary liver cancer necessitation periodic follow-up examination. This study was performed to evaluate the effectiveness of a reminding letter on the compliance with scheduled follow-up examination in chronic HBsAg-positive patients.

Methods : A randomized controlled clinical trial was conducted at a Family Practice Clinic in Samsung Medical Center located in Seoul from February 1998 to January 1999. A total of 178 HBsAg-positive patients who had no other clinical illnesses and were scheduled to take follow-up examination were randomly assigned to a control (88 subjects) and a letter reminder group (88 subjects).
The outcome measure and attendance at the scheduled follow-up examination were determined through the medical chart review and telephone. Demographic and clinical characteristics were checked through the medical chart review.

Results : The attendance rate was 62.2% among the 82 patients who were actually receiving the letter reminders. Compared to the attendance rate of 37.5% among the control group, it was significantly higher. Even after controlling the demographic and clinical characteristics through the multiple logistic regression analysis, the letter reminder was significantly related to the increased compliance for a scheduled follow-up examination. Frequency of previous visit was also positively related to increased compliance.

Conclusion : These results suggest that the letter reminder can significantly improve compliance with a scheduled follow-up examination in HBsAg-positive patients.
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Original Articles
Compliance with anti-tuberculosis therapy of pulmonary tuberculosis patients.
Chang Woo Rhee, Choong Hun Han, Shin Ae Lim, Hong Jun Cho
J Korean Acad Fam Med 2000;21(5):684-692.   Published online May 1, 2000
Background
: Tuberculosis is still one of the major public health problems in Korea. The patient's compliance with anti-tuberculosis therapy is the most important matter in managing tuberculosis. Research, particularly on this issue, is needed. Therefore, we analyzed the factors associated with compliance of pulmonary tuberculosis patients using the Health Belief Model.

Methods : One hundred and 47 patients who visited the outpatient Department of Family Medicine in Asan Medical Center from January 1995 to December 1998, and who were diagnosed as having pulmonary tuberculosis and treated with anti-tuberculosis drug were chosen through chart reviews. Questions were given by telephone with questionnaire based on Health Belief Model.

Results : One hundred and two patients out of the total 147 participated in the study. The group was divided into two: 79 patients as a compliance group, and 23 as a non-compliance group. Recognition of their diagnosis, recognition of the duration of taking anti-tuberculosis drugs, disturbance of daily living with taking the drugs, efficacy expectations were statistically significant factors between the two groups.

Conclusion : Higher the knowledge about their diagnosis as having tuberculosis, higher their knowledge about the durations of having to take the anti-tuberculosis drugs, less disturbance they had experieced on their daily living, and higher their expectation for the efficacies of taking the drugs resulted in higher compliance with anti-tuberculosis medication.
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The comparison of recognition between non-medicated and medicated group in hypertensive patients.
Doo Young Choi, Chang Sup Kim, Eun Ju Sung, Young Sik Kim
J Korean Acad Fam Med 2000;21(3):406-414.   Published online March 1, 2000
Background
: With proper management, hypertensive patients can maintain their health and prevent complications. But poor compliance is a main problem for management of hypertension. This study was designed to investigate the reasons among hypertensive patients who did not initiate antihypertensive medication despite recommendations.

Methods : Questionnaires were used for hypertensive patients who visited a health care center and an outpatient clinic of family department in a university hospital, from March to July, 1998. The non-medicated (noncompliant) group were those who had not taken antihypertensive drug at all with high blood pressure (higher than 160mmHg at systolic, or 100mmHg at diastolic phase initially and hypertensive range on the follow up), despite doctor’s recommendations. The medicated(compliant) group were those hypertensive patients who had taken antihypertensive drug well and visited the clinic regularly at least for 9 months during the recent 12 months.

Results : The total number of the noncompliant was 65, and the compliant 57. The mean age of the noncompliant was 50.8 and the compliant 58.0 years old. The mean blood pressure in the noncompliant was 162.6/106.6mmHg, higher than in the compliant 138.1/85.7mmHg. The main reasons refusing antihypertensive drug were fearful feeling for ‘lifelong medication’ (47.7%), followed by complications form drugs(30.8%). The reason for delaying treatment with antihypertensive drug is that the noncompliant showed more tendency to think ‘It would be the same’, or ‘better than starting medication early’ than the compliant. For the complications from drugs, 59.5% of the noncompliant answered. ‘I’m not sure, but it’ll be not good’, and those who answered ‘it’ll be not bad to have medication’ seemed to be less than in the noncompliant.

Conclusion : The patients who had been recommended but did not start on medication had less knowledge about the benefits of medication. We can assume that they are refusing antihypertensive because of their excessive anxiety about complications of and lifelong medication.
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Compliance with lifestyle modification in patients with hypertension.
Byung Kwan Lee, Yun Mi Song, Kong Jin Kim, Sung Ho Do
J Korean Acad Fam Med 1999;20(12):1709-1720.   Published online December 1, 1999
Background
: Advising lifestyle modification to patients suffering from hypertension is important. However, how strictly hypertensive patients in Korea are adherent to non-pharmacologic recommendation has not been well known. This study was performed to determine the compliance of hypertensive patients to the recommendation for life style modification and to find out on factors related to compliance.

Methods : Ninety ? six patients, diagnosed as hypertensive between November 1997 and April 1998 in the Department of Family Medicine, Samsung Medical Center were educated on lifestyle modifications by their physicians during routine outpatient consult questionnaires inquiring of demographic and clinical characteristics, and health habits were Self administered done before and after the education. Blood pressure, height, and weight were measured repeatedly. The relationships between various characteristics and the compliance with lifestyle modification and follow-up visits were evaluated using Chi-square test and multiple logistic regression analysis.

Results : Among 96 patients, 47 patients(49.0%) attended for regular check-up two months after being diagnosed as hypertension. Being prescribed with antihypertensive agent, non-smoking, and doing regular exercise were the significant factors related to higher compliance with regular check-up. A total of 19 patients (40.4%) among 47 patients who have attended for regular check-up were adherent to the recommendation for modification of one or more health habits. The proportion of patients doing regular exercise increased significantly after education. Although 15 patients(53.6%) among 28 patients whose body mass indices were over 25 km/㎡ reported that they had made efforts to reduce body weight, no significant differences were observed in the change of body mass index between patients who reported their efforts for reducing body weight and those who did not. There was no association between various characteristics and compliance with lifestyle modification.

Conclusion : Low compliance with recommendation for lifestyle modification during routine outpatient consultation and no association between various clinical and demographic characteristics and patient compliance suggests the necessity of developing special program and its active application to all hypertensive patients. ( J Korean Acad Fam Med 1999;20:1709-1720)
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Medication compliance in the elderly and the factors associated with compliance.
Kyong Chol Kim, Ju Tea Kim, Ji Sun Kim, Hang Suk Cho, Jae Yong Shim, Hye Ree Lee
J Korean Acad Fam Med 1999;20(10):1216-1223.   Published online October 1, 1999
Background
: Compliance, defined as the extent to how a person's behavior concedes with medical prescription or advice, has great influence on the treatment. Compliance can be a problem when dealing with chronic medical disorder requiring lifestyle changes and long term treatment. Elderly patients are thought to have more difficulty following prescription because they are generally prescribed more medication, and have more chronic disease. Thus we conducted this study to exam the medication compliance, and the factors associated with compliance in elderly patients.

Methods : The study population consisted of 60 patients (men 31,women 29), older than 60years, who visited a geriatric center geriatric center in a university hospital in September 1, 1998 for one week. We used morisky's self-reported questionnaire which consisted of 4 questions by telephone interview to figure out compliance, and asked 11 questions that may influence compliance, and then collected data - sex, age, number of medication, complexity of prescription, physician number, follow-up days etc. by medical records. We defined compliance as given positing answers to all of the four questions. We analyzed the correlation between compliance and associated factors with x2- test.

Results : Twenty one patients(35%) of the 60 patients were non-compliant. The factors associated with medication compliance were knowledgement of the disease (p=0.020), satisfaction with physician(p=0.012),explanation from physician (p=0
050), number of physician (p=0.024), number of dedication (p=0007), complexity of prescription (p=0.002). But there was no relationship between medication compliance and sea, age, education, perceived seriousness of illness, perceived efficacy of treatment, family support, physical disability, treatment duration, adverse effect, and follow-up days.

Conclusion : Thirty five percent of the subjects were non-compliant. In the factors associated with compliance, the doctor/patient factors as satisfaction with physician, number of physician, number of medication, complexity of prescription have more correlation than patient/disease factor Therefore, we emphasize the role of doctor for improving medical compliance.
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The change of health-related behavior after health examination.
Kyeong Soo Cheon, Mi Kyeong Oh, Yeong Jeon Shin, Bo Youl Choi
J Korean Acad Fam Med 1999;20(8):1012-1026.   Published online August 1, 1999
Background
: In a health examination program, advice from physician for change of health-related behavior and distribution of health educational pamphlets is routine. This study was done prospectively to analyze factors such as personal general characteristics, results of health examination, health examination satisfaction that related to change of health promotion attitudes and compliance towards overweight, smoking, heavy drinking, elevated blood pressure, dyslipidemia, chronic diseases such as diabetes, hypertension.

Methods : The subject population was 689 cases from May 1997 to Jue 1997i a general hospital health examination center. After health examination, 60.2%(415 cases) showed personal satisfaction by questionnaire. Three to four months later 78.4%(540 cases) responded to eh telephone survey on change of health beliefs, health-related attitudes and compliance.

Results : In the telephone survey, 239 cases(46.0%) comprised high compliance group that had positive attitudes toward abnormal health examination results, 145 cases(27.9%) were mid compliance group. In males there was higher frequency of high compliance group than females(p<0.05). According to age, the older, the higher frequencies of high compliance group(p<0.05). In educational level group, the higher the educational level, the lower the frequencies of high compliance group(p<0.01). There was no difference in frequency of each compliance group between symptom motive and non-symptom motive group with each satisfaction group(p>0.05). In positive responders to the correspond advice of physician or health educational pamphlets, the frequencies for quit smoking, reduction of drinking amount, regular exercise, Compliance with taking antihypertensive, blood sugar control, diet control for dyslipidemia, taking antihyperlipidemics were higher(p<0.01).

Conclusion : Health examination service including advice of physician and education changed health belief and influenced positively to health promotion attitudes. Health examination is not only important for early detection of disease but also to promote positive change of health-related behavior. Further studies are needed to understand the changing process of management of health and disease.( J Korean Acad Fam Med 1999;20:1012-1026)
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The Compliance of the Patients advised Additional Laboratory Test or Treatment in the Periodic Health Screening.
Kyoung Ah Yoon, Jin Yi Kang, Jung Jin Cho
J Korean Acad Fam Med 1998;19(3):292-300.   Published online March 1, 1998
Background
: Recent increase in use of the periodic health screening is due to a concern for health. But study of patient's compliance with recommended periodic health screening has not yet been conducted. This study was accomplished to clarify which aspect to be considered in order to increase patient's compliance after health screening.

Methods : This study was done from March 3 to May 15 in 1997 by Hanil health care center. Among 370 workers in a state-run corporation who received health screening two years ago, 170 men were advised to receive and additional laboratory test or treatment at the time. They were asked to fill out a questionnaire and were interviewed by doctors to evaluate their compliance. 162 of 170 patients(95.3%) were enrolled in the study, except 8 patients who did not answer the questionnaire.

Results : The mean age of patients was 54 years. Most of them were technicians and managers, graduated from high school or higher, and had an annual income of at least 35,000,000. The disease of requiring an additional test or treatment were in the order of liver disease, hypertension, gastrointestinal disease, urologic disease and abnormal urinalysis. 68 patients(42%) were compliant and 94 patients(58%) were noncompliant. For reasons of noncompliance, 27 patients(28.7%) answered "because I had no symptoms", 20 patients(21.2%) answered "because I didn't think I needed the test or the treatment" and 12 patients(12.7%) answered "because I was busy". The factors influencing compliance were analyzed through chi-square or Fisher's exact test. Their compliance was highly related to the patients' insight into the necessity of the test, the existing disease, and the reporting method of the health screening results. It was not associated with the patients' feeling about their health status, the health behaviors such as smoking and drinking, occupational factors, distance from thire homes to the hospital, or the presence of a hospital near home for those who didn't live in Seoul. The independent effect of the factors influencing the compliance was evaluated by means of stratified analysis. The only independent factor associated with the compliance was the patients' insight. The compliance according to diseases was higher than average in hypertension, liver disease, diabetes mellitus and urologic disease, and lower than average in pulmonary disease, gastrointestinal disease, thyroid disease, cardiac disease, opthalmologic disease and abnormal urinalysis.

Conclusion : The most influencing factor related to compliance was the patient's insight into the necessity of the further testing. We should consider a proper way to increase compliance on health screening. Direct counseling, if possible, is recommended following health screening and way to increase patient's compliance utilising mail report as another.
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