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印度卡纳塔克邦一个农村社区中老年人对慢性病规定药物的依从性。

Adherence to prescribed medications for chronic illnesses among older adults in a rural community, Karnataka, India.

作者信息

Hegde Shailendra Kumar B, Fathima Farah Naaz, Agrawal Twinkle, Misquith Dominic

机构信息

Department of Community Medicine, SRM Medical College and Research Centre, Kanchipuram District, Tamil Nadu, India.

Department of Community Health, St. John's Medical College, Bangalore, Karnataka, India.

出版信息

Geriatr Gerontol Int. 2016 Dec;16(12):1339-1345. doi: 10.1111/ggi.12637. Epub 2015 Oct 13.

Abstract

AIM

To assess adherence to prescribed medications for chronic illnesses and to identify factors associated with it among rural older adults.

METHODS

A cross-sectional study was carried out from September to November 2011 in three subcenters in Lakkur PHC, Kolar District, India. All older adults were listed, and those suffering from chronic non-communicable diseases were included in the study. A structured interview schedule comprising of 48 items was used to measure adherence, and to identify factors associated with adherence in the domains of socioeconomic status, therapy, health systems, patient behavior and physical factors.

RESULTS

Of the 184 older adults included in the study, 63.6% were fully adherent to their medication. Non-adherence to medication showed a statistically significant relationship with the absence of a medical store within their village, non-availability of drugs at the nearest medical store, inability to understand the doctor's language, failure to explain the consequences of not taking medicines by the healthcare provider, self-alteration of medicine dosage, fear that medicines will lead to the development of dependence to medicines and difficulty in swallowing. Those who led busy lives, those who had been prescribed three or more types of medicines prescribed per day, those who required special skills to take medicines (injections, inhalers), those who had made adjustments to their usual lifestyle to take medicines and those who had knowledge that medicines need to be taken lifelong were more likely to be adherent to their medications. Four factors, namely, the doctor explaining the consequences of not taking medicines, altering the dosage of the medicines by the patients themselves, the number of medicines prescribed per day and having the knowledge that medicines need to be taken lifelong, were critical determinants of adherence to medications. Geriatr Gerontol Int 2016; 16: 1339-1345.

摘要

目的

评估农村老年人对慢性病规定药物的依从性,并确定与之相关的因素。

方法

2011年9月至11月在印度科拉尔区拉克库尔初级卫生保健中心的三个分中心开展了一项横断面研究。列出所有老年人,将患有慢性非传染性疾病的老年人纳入研究。使用一份包含48个条目的结构化访谈问卷来衡量依从性,并确定在社会经济状况、治疗、卫生系统、患者行为和身体因素等领域中与依从性相关的因素。

结果

在纳入研究的184名老年人中,63.6%完全依从其药物治疗。不依从药物治疗与以下因素存在统计学上的显著关系:其村庄内没有药店、最近的药店没有药品、无法理解医生的语言、医护人员未解释不服用药物的后果、自行改变药物剂量、担心药物会导致药物依赖以及吞咽困难。生活忙碌的人、每天被开三种或更多种药物的人、需要特殊服药技能(注射、吸入器)的人、为了服药而调整了日常生活方式的人以及知道药物需要终身服用的人更有可能依从其药物治疗。四个因素,即医生解释不服用药物的后果、患者自行改变药物剂量、每天开的药物数量以及知道药物需要终身服用,是药物治疗依从性的关键决定因素。《老年医学与老年病学国际杂志》2016年;16: 1339 - 1345。

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