George Johnson, Munro Kim, McCaig Dorothy J, Stewart Derek C
School of Pharmacy, The Robert Gordon University, School-hill, Aberdeen, Scotland.
Ann Pharmacother. 2006 Dec;40(12):2123-9. doi: 10.1345/aph.1H355. Epub 2006 Oct 31.
Data on medication utilization among residents of sheltered housing complexes (SHCs) are limited.
To evaluate the extent of nonadherence to prescribed medications among residents of SHCs and identify factors associated with nonadherence.
A 58 item, pre-piloted questionnaire with validated items for patient self-assessment of medication risk; adherence; disability; health beliefs, experiences, and behavior; and general items on demographics, health, and medication use was mailed to 1137 SHC residents in Aberdeen, Scotland. Predictors of nonadherence (Morisky score >0) were identified using logistic regression.
Of the 695 (61.1%) respondents, 645 (mean +/- SD age, 78.2 +/- 7.8 y) reported using prescribed drugs. Nonadherence was reported by 176 of 627 (28.1%) residents. The predictors of nonadherence were: disagreeing with the statement, "I ensure I have enough medicines so that I don't run out" (OR 0.48; 95% CI 0.30 to 0.77), agreeing with the statements, "I make changes in the recommended management to suit my lifestyle" (OR 1.32; 95% CI 1.09 to 1.60) and "I get confused about my medicines" (OR 1.39; 95% CI 1.10 to 1.77), younger age (OR 0.96; 95% CI 0.94 to 0.99), not getting help from someone to use the medications correctly (OR 2.20; 95% CI 1.21 to 3.99), and agreeing with the statement, "I am concerned about the side effects from my medicines" (OR 1.31; 95% CI 1.05 to 1.63).
Over one-quarter of SHC residents were found to be nonadherent to prescribed drugs. Risk factors for nonadherence include younger age, confusion about drugs, lack of support for drug supply and administration, interference of treatment recommendations with lifestyle, and a perceived view of risks outweighing benefits in using recommended drug therapy.
关于庇护性住房小区(SHC)居民用药情况的数据有限。
评估SHC居民中不遵医嘱用药的程度,并确定与不遵医嘱相关的因素。
一份包含58个条目的预试验问卷,其中部分条目经过验证可用于患者自我评估用药风险、依从性、残疾情况、健康观念、经历及行为,以及关于人口统计学、健康和用药情况的一般条目。该问卷被邮寄给苏格兰阿伯丁市1137名SHC居民。使用逻辑回归确定不遵医嘱(Morisky评分>0)的预测因素。
在695名(61.1%)受访者中,645名(平均年龄±标准差,78.2±7.8岁)报告使用处方药。627名居民中有176名(28.1%)报告不遵医嘱。不遵医嘱的预测因素包括:不同意“我确保有足够的药物,以免用完”这一说法(比值比[OR]0.48;95%置信区间[CI]0.30至0.77),同意“我会改变推荐的治疗方案以适应我的生活方式”(OR 1.32;95% CI 1.09至1.60)和“我对我的药物感到困惑”(OR 1.39;95% CI 1.10至1.77),年龄较小(OR 0.96;95% CI 0.94至0.99),在正确用药方面未得到他人帮助(OR 2.20;95% CI 1.21至3.99),以及同意“我担心药物的副作用”这一说法(OR 1.31;95% CI 1.05至1.63)。
发现超过四分之一的SHC居民不遵医嘱用药。不遵医嘱的风险因素包括年龄较小、对药物感到困惑、在药物供应和管理方面缺乏支持、治疗建议与生活方式相冲突,以及认为使用推荐药物治疗的风险大于益处。