Jones GaToya, Tabassum Vajeeha, Zarow Gregory J, Ala Thomas A
Southern Illinois University School of Medicine, Springfield, IL, USA.
Drugs Aging. 2015 Apr;32(4):329-36. doi: 10.1007/s40266-015-0255-z.
BACKGROUND/OBJECTIVES: Previous research has shown that many older adults without known cognitive impairment are unable to recall basic knowledge about their medical history. We sought to determine whether older adult patients in our own clinic population were able to recall their drug regimens and medical conditions from memory.
Patients aged 65 years or older with no known cognitive impairment, dementia, or memory loss who were presenting for routine outpatient follow-up in our medical school neurology and general medicine clinics were recruited. Each patient was asked to recall the number and names of their presently prescribed drugs and their associated medical conditions. Each patient was also administered a Mini-Mental State Examination (MMSE) cognitive screening test (range 0-30).
Most patients were unable to recall their drug regimens or their medical conditions. Of 99 patients taking drugs, only 22% correctly named their drugs from memory, and only 34% correctly named their medical conditions associated with the drugs. Fewer than half (49%) correctly recalled the number of drugs they were taking. Poor recall performance was evident even in high-cognitive (MMSE>27) patients.
The accuracy of recall memory in older adults regarding their drugs and medical conditions may be poor, which has important implications towards medication reconciliation within meaningful-use doctrine. Clinicians treating older adults should be very cautious before relying on their patients' memories for accurate recall of their medical conditions, their drug regimens, and even the number of drugs they are taking.
背景/目的:先前的研究表明,许多无已知认知障碍的老年人无法回忆起其病史的基本知识。我们试图确定我们诊所人群中的老年患者是否能够凭记忆回忆起他们的药物治疗方案和病情。
招募年龄在65岁及以上、无已知认知障碍、痴呆或记忆丧失且在我们医学院神经科和普通内科诊所进行常规门诊随访的患者。每位患者被要求回忆其当前所开药物的数量和名称以及相关病情。每位患者还接受了简易精神状态检查表(MMSE)认知筛查测试(范围为0 - 30)。
大多数患者无法回忆起他们的药物治疗方案或病情。在99名正在服药的患者中,只有22%能凭记忆正确说出他们的药物名称,只有34%能正确说出与药物相关的病情。不到一半(49%)的患者能正确回忆起他们正在服用的药物数量。即使在高认知(MMSE>27)的患者中,回忆表现也很差。
老年人对其药物和病情的回忆准确性可能很差,这对符合有意义使用原则的用药核对具有重要意义。治疗老年人的临床医生在依靠患者的记忆来准确回忆其病情、药物治疗方案甚至所服用药物数量之前应非常谨慎。