Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, 221 00 Lund, Sweden.
Eur J Clin Pharmacol. 2010 Oct;66(10):1047-54. doi: 10.1007/s00228-010-0837-y. Epub 2010 Jul 22.
The aim of this study was to explore healthcare consumption in relation to more versus less knowledge concerning prescribed drugs among older people with functional dependency and repeated healthcare contacts, and to explore the determinants of more versus less knowledge
The sample comprised 63 persons (mean age 82.8 years). Data concerning use and knowledge about drugs, demographics, health complaints and self-reported diseases were collected from the baseline measure in an ongoing randomised controlled trial (RCT) and merged with data from two public registers about healthcare consumption 2 years prior to baseline measurement. Data were analysed descriptively and using regression analysis.
Fifty-two percent of the sample (n = 33) had less knowledge (defined as not knowing the indications for 50% or less of their prescribed drugs) and these had more acute hospitals stays (median 2 vs 0), more total hospital stays (median 2 vs 1) and more bed days in hospital (median 18 vs 3) than those with more knowledge. Bed days and visits to other outpatient staff groups were associated with less knowledge; visits to physicians were associated with more knowledge.
The healthcare consumption pattern of those with less knowledge differed from that of those with more knowledge in terms of more acute inpatient care. The results indicate that there is a need for the health system to create mechanisms to ensure that patients do not lose their knowledge about their drugs when admitted in an acute situation; there is also an apparent need for educational intervention with patients, starting at the time of admission.
本研究旨在探讨与功能依赖和反复医疗接触的老年人更多或更少了解处方药相关的医疗保健消费,并探讨更多或更少了解药物的决定因素。
该样本包括 63 人(平均年龄 82.8 岁)。从正在进行的随机对照试验(RCT)的基线测量中收集了关于药物使用和知识、人口统计学、健康投诉和自我报告疾病的数据,并与基线测量前两年两个公共医疗保健消费登记处的数据合并。数据进行了描述性分析和回归分析。
样本的 52%(n=33)的知识较少(定义为对 50%或更少的处方药物的适应症不了解),与知识较多的人相比,这些人有更多的急性住院治疗(中位数 2 次对 0 次)、更多的总住院治疗(中位数 2 次对 1 次)和更多的住院天数(中位数 18 天对 3 天)。住院天数和其他门诊工作人员群体的就诊次数与知识较少相关;而就诊于医生与更多的知识相关。
在急性住院治疗方面,知识较少的人与知识较多的人的医疗保健消费模式不同。结果表明,卫生系统需要建立机制,确保患者在急性情况下不会失去对药物的了解;显然也需要对患者进行教育干预,从入院时开始。