School of Healthcare, University of Leeds, Leeds, UK.
Drugs Aging. 2011 May 1;28(5):403-14. doi: 10.2165/11587180-000000000-00000.
Low adherence of older people to multiple medicine regimens is of widespread concern, and multi-compartment compliance aids are frequently supplied to older people in an attempt to improve their ability to take all their medicines at home. However, the evidence base for the use of such aids is very limited, and there is some evidence that they are used inappropriately.
We aimed to determine how the attitudes and beliefs of older people and healthcare professionals impacted on the use of multi-compartment compliance aids by older people living at home.
This was a qualitative study using grounded theory. Semi-structured interviews were conducted with 15 older people (mean age 82 [range 72-92] years) living independently in the community and receiving primary healthcare from two health service organizations in a large northern UK city. We then interviewed 17 healthcare professionals working in primary, secondary or intermediate care and involved in the provision of multi-compartment compliance aids.
Maintaining independence and remaining in control was important for all the older people interviewed, and professionals supported the view that this influenced patients' attitudes towards using their aid. Some patients saw the aids as helping to maintain independence, others as casting doubt on their independence. The aids were often issued without discussion with the patient. The patients largely agreed that the aids did not help with memory problems and that the decision to issue an aid could be seen as paternalistic. A minority of patients had difficulties using the aids.
Careful multi-disciplinary assessment of older people is required before a compliance aid is provided. The views of the older person must be considered and respected. Further research is required to produce an evidence base for the use of such aids in this group of people.
老年人普遍存在不遵医嘱服用多种药物的情况，为了提高他们在家中按时服药的能力，常给老年人提供多剂量用药辅助器具。然而，目前关于此类辅助器具使用的证据非常有限，且有证据表明其使用不当。
我们旨在确定老年人及其医护人员的态度和信念如何影响居家老年人对多剂量用药辅助器具的使用。
这是一项采用扎根理论的定性研究。在英国北部一个大城市的两个卫生服务机构中，对 15 名独立生活在社区且接受初级医疗保健的老年人（平均年龄 82 岁[72-92 岁]）进行了半结构式访谈。然后，我们对 17 名从事初级、二级或中级护理工作并参与提供多剂量用药辅助器具的医护人员进行了访谈。
对所有接受访谈的老年人而言，保持独立性和掌控权非常重要，医护人员也支持这一观点，即这种态度会影响患者对使用辅助器具的看法。一些患者认为这些器具有助于保持独立性，而另一些患者则认为这些器具对其独立性表示怀疑。辅助器具通常在未经与患者讨论的情况下发放。患者大多认为这些器具无助于解决记忆问题，而发放辅助器具的决定可能被视为家长式作风。少数患者在使用辅助器具方面存在困难。
在发放用药辅助器具之前，需要对老年人进行多学科的仔细评估。必须考虑并尊重老年人的意见。需要进一步研究，为这组人群使用此类辅助器具提供证据基础。
