Department of Emergency Medicine, Holbæk University Hospital, Holbæk, Denmark ; Department of Geriatrics, Gentofte University Hospital, Copenhagen, Denmark.
Division of Cardiology, Department of Medicine, Holbæk University Hospital, Holbæk, Denmark.
Clin Interv Aging. 2014 Apr 16;9:705-10. doi: 10.2147/CIA.S61850. eCollection 2014.
Higher prevalence of multiple illnesses and cognitive impairment among older patients pose a risk of comprehension difficulties, potentially leading to medication errors. Therefore, the objective of this study was to investigate comprehension of discharge instructions among older patients admitted to a Quick Diagnostic Unit (QDU).
One hundred and two patients discharged from the QDU answered a questionnaire covering understanding of their hospitalization and discharge plan. Patients' ability to recall discharge instructions and awareness of comprehension deficits, ie, ability to identify the misconceived information, were evaluated by comparing the questionnaires with the discharge letters. The population was divided into an older group (age ≥65 years) and a younger group.
The older group (n=40) was less able to recall correct medication instructions when compared to the younger group (54% versus 78%, respectively; P=0.02). In multiple logistic regression analysis, correct recall of medication instructions was 4.2 times higher for the younger group compared to the older group (odds ratio 4.2, 95% confidence interval 1.5-11.9, P=0.007) when adjusted for sex and education. The older patients were less aware of their own comprehension deficits, and in respect to medication instructions awareness decreased 6.1% for each additional year of age (odds ratio 0.939, 95% confidence interval 0.904-0.98, P=0.001) when adjusted for sex and education.
Older patients were less able to recall correct medication instructions and less aware of their comprehension deficits after discharge from a QDU. The findings of the present study emphasize the importance of thorough communication and follow-up when treating older patients.
老年患者多种疾病和认知障碍的患病率较高，存在理解困难的风险，可能导致用药错误。因此，本研究旨在调查入住快速诊断单元（QDU）的老年患者对出院医嘱的理解情况。
102 名从 QDU 出院的患者回答了一份问卷，涵盖了对住院和出院计划的理解。通过比较问卷和出院信，评估了患者回忆出院医嘱的能力以及对理解缺陷的认识（即识别误解信息的能力）。将人群分为老年组（年龄≥65 岁）和年轻组。
与年轻组相比，老年组（n=40）更难以正确回忆正确的药物医嘱（分别为 54%和 78%；P=0.02）。在多变量逻辑回归分析中，与老年组相比，年轻组正确回忆药物医嘱的可能性高 4.2 倍（优势比 4.2，95%置信区间 1.5-11.9，P=0.007），校正性别和教育程度后。老年患者对自己的理解缺陷的认识程度较低，而且，每增加 1 岁，对药物医嘱的认识程度降低 6.1%（比值比 0.939，95%置信区间 0.904-0.98，P=0.001），校正性别和教育程度后。
与年轻患者相比，老年患者出院后更难以回忆正确的药物医嘱，对自己的理解缺陷的认识程度较低。本研究的结果强调了在治疗老年患者时，彻底沟通和随访的重要性。
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