Freigofas Julia, Seidling Hanna Marita, Quinzler Renate, Schöttker Ben, Saum Kai-Uwe, Brenner Hermann, Haefeli Walter Emil
Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
Eur J Clin Pharmacol. 2015 Sep;71(9):1109-20. doi: 10.1007/s00228-015-1888-x. Epub 2015 Jun 24.
We investigated the prevalence and quality of medication schedules of elderly ambulatory patients and assessed factors associated with the availability of a medication schedule. In particular, we evaluated whether sending out a blank medication schedule template would increase the chances to use such a document.
Data originate from the ESTHER study, a cohort study conducted in Saarland, Germany, in which trained study physicians performed home visits. They scanned all medication schedules, recorded the participants' medication, and performed thorough geriatric assessments. As part of the intervention, a blank medication schedule template along with a brochure was mailed to half of the participants (intervention group) 4 weeks prior to the home visits.
In total, 553 of 2470 participants (22.4 %) had a medication schedule. Almost two thirds of the schedules were issued by health care professionals (n = 353, 63.8 %). These schedules offered a higher quality, although important information such as over-the-counter (OTC) medication was regularly missing. Self-reported adherence was higher in participants who used self-issued medication schedules; however, self-reported medication adherence in patients with any medication schedule was poorer compared to those patients not using a schedule. Factors associated with the availability of a medication schedule were male sex, a higher number of medicines to take, and a more complex drug regimen. The intervention did not increase the number of patients having a medication schedule.
Only a minority of elderly ambulatory patients had a medication schedule at home. Sending out a brochure along with a blank medication schedule template did not increase the prevalence of medication schedules.
我们调查了老年门诊患者用药计划的普及率和质量,并评估了与用药计划可用性相关的因素。特别是,我们评估了发放空白用药计划模板是否会增加使用此类文件的机会。
数据源自ESTHER研究,这是一项在德国萨尔州进行的队列研究,由经过培训的研究医生进行家访。他们扫描了所有用药计划,记录参与者的用药情况,并进行全面的老年评估。作为干预措施的一部分,在进行家访前4周,向一半的参与者(干预组)邮寄了一份空白用药计划模板和一本宣传册。
在2470名参与者中,共有553人(22.4%)有用药计划。近三分之二的用药计划由医护人员发放(n = 353,63.8%)。这些用药计划质量较高,不过诸如非处方药(OTC)等重要信息经常缺失。使用自行发放用药计划的参与者自我报告的依从性较高;然而,与未使用用药计划的患者相比,有任何用药计划的患者自我报告的用药依从性较差。与用药计划可用性相关的因素包括男性、服用的药物数量较多以及药物治疗方案更复杂。干预措施并未增加有用药计划的患者数量。
只有少数老年门诊患者家中有用药计划。随空白用药计划模板一起发放宣传册并未提高用药计划的普及率。