Botelho R J, Dudrak R
Department of Family Medicine, University of Rochester, New York 14620.
J Fam Pract. 1992 Jul;35(1):61-5.
Drug nonadherence to long-term medication is a common and poorly understood problem in the elderly. A study was conducted to assess whether elderly patients would accept a research assistant conducting pill counts in their homes, and to examine how nonadherence was associated with patient variables.
A letter and a telephone follow-up call were used to identify eligible patients (aged 65 years and over, with two or more chronic diseases).
A total of 98 eligible patients were identified. Fifty-nine agreed to participate in the study. Of the 59 participants, 54.7% were nonadherent to their medication regimen. Nonadherence was defined as an overall mean level of compliance of less than 80%. Drug regimen nonadherence was associated with the inability to read medication labels (P less than .01), but not with impaired visual acuity, the number of prescribed medications, the type of medication container lid, depression, cognitive impairment, perceived health status, or the cost of medications. Frequency of drug administration affected patient adherence to the medication regimen. Mean adherence of patients to prescriptions for drugs to be taken once or twice daily was 72%, whereas drugs to be taken three or four times daily had a mean adherence rate of 54% (P less than .01).
Using the simple pill count method on home visits, rates of nonadherence to long-term medication were comparable to those found in studies using electronic pill-counting devices. Larger studies are needed to clarify how other variables, in addition to patient inability to read medication labels, are associated with noncompliance with medication regimens for chronic diseases in elderly patients.
老年患者长期用药不依从是一个常见且了解不足的问题。开展了一项研究，以评估老年患者是否会接受研究助理到其家中清点药片，并研究不依从与患者变量之间的关联。
通过信件和电话随访来确定符合条件的患者（年龄65岁及以上，患有两种或更多种慢性病）。
共确定了98名符合条件的患者。59名患者同意参与研究。在这59名参与者中，54.7%的患者未坚持用药方案。不依从被定义为总体平均依从水平低于80%。用药方案不依从与无法读懂药品标签有关（P<0.01），但与视力受损、处方药数量、药瓶瓶盖类型、抑郁、认知障碍、自我感知健康状况或药品费用无关。给药频率影响患者对用药方案的依从性。患者对每日服用1次或2次药物处方的平均依从率为72%，而每日服用3次或4次药物的平均依从率为54%（P<0.01）。
通过在家访中使用简单的清点药片方法，长期用药的不依从率与使用电子药片计数设备的研究结果相当。需要开展更大规模的研究，以阐明除患者无法读懂药品标签外，其他变量如何与老年患者慢性病用药方案的不依从相关。
