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老年人的依从性。

Compliance in the elderly.

作者信息

Weintraub M

机构信息

Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, New York.

出版信息

Clin Geriatr Med. 1990 May;6(2):445-52.

PMID:2331663
Abstract

Noncompliance is not a unique phenomenon associated with aging. Many of the same problems concerning taking medications most appropriately apply to 40 year olds as well as to 80 year olds. What is unique about the elderly is their greater sensitivity to medications, their greater propensity for the development of adverse effects, and the greater complexity of their regimens as they develop chronic illnesses through the course of their lives. In addition, decreasing acuity of special senses, problems with memory, and the interposition of other caregivers are all unique phenomena that have to be dealt with through expansion of the standard methods but only rarely through specific methods. Utilization of modern technology such as video cassette recorders, large print reproductions, and improved communication modalities for people with hearing and sight disabilities may overcome some of the problems leading to decreased comprehension and communication ability in elderly patients. Similarly, for those with financial barriers to appropriate utilization of medications, programs such as the Elderly Pharmaceutical Insurance Coverage (EPIC) in New York State may be helpful. Medicaid and AARP programs for obtaining medications at lower prices can help financially strapped patients. The necessity for physicians to learn about cultural attitudes toward family and governmentally supplied caregivers may also facilitate optimal medication utilization in our polycultural society. Medications can serve the elderly to great benefit. Misapplication and misuse of medications may result in undesirable outcomes, ranging from lack of maximum efficacy, annoying nuisance side effects, diminishing quality-of-life, and even life-threatening adverse outcomes.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

不依从并非衰老所特有的现象。许多关于正确用药的相同问题在40岁人群和80岁人群中都同样存在。老年人的独特之处在于他们对药物更为敏感,出现不良反应的倾向更大,并且随着他们在一生中患上慢性疾病,其用药方案也更为复杂。此外,特殊感官敏锐度下降、记忆问题以及其他护理人员的介入都是独特的现象,必须通过扩展标准方法来应对,但很少需要采用特定方法。利用现代技术,如录像机、大字印刷品以及为听力和视力有障碍者改进的沟通方式,可能会克服一些导致老年患者理解和沟通能力下降的问题。同样,对于那些在合理用药方面存在经济障碍的人,纽约州的老年药物保险覆盖计划(EPIC)等项目可能会有所帮助。医疗补助和美国退休人员协会以较低价格获取药物的项目可以帮助经济困难的患者。医生了解文化对家庭和政府提供的护理人员的态度的必要性,也可能有助于在我们这个多元文化社会中实现最佳用药。药物可以给老年人带来很大益处。药物的误用和滥用可能会导致不良后果,从无法达到最大疗效、恼人的副作用、生活质量下降,甚至危及生命的不良后果。(摘要截选至250字)

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