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检查健康素养与老年人用药依从性之间的关系。

Examining the Association Between Health Literacy and Medication Adherence Among Older Adults.

机构信息

a Department of Family and Community Medicine , Meharry Medical College.

b Office of Academic Affairs , University of Texas Medical Branch.

出版信息

Health Commun. 2018 Sep;33(9):1124-1130. doi: 10.1080/10410236.2017.1331311. Epub 2017 Jun 21.

DOI:10.1080/10410236.2017.1331311
PMID:28636404
Abstract

Health literacy plays a vital role in patients' understanding of their prescribed medication instructions. To inform strategies to assist providers in communicating in a manner that is easily understood by patients, it would be beneficial to determine the relationship between health literacy and the day-to-day aspects of medication adherence. This study identified: 1) differences of health literacy levels in medication adherence; 2) the association between health literacy and medication adherence; and 3) and factors associated with medication adherence score. A convenience sample of older predominantly African-American patients (N = 389), over the age of 60, completed a cross-sectional survey. Chi-square analysis assessed health literacy differences in five aspects of medication adherence. Ordinary linear regression analysis determined factors associated with medication adherence score. Patients with limited health literacy were more likely to forget to take their medications and more likely to take less medication than instructed than patients with adequate health literacy (χ(5) = 15.91, p = .007, χ(5) = 10.31, p = .036, respectively). REALM score was also significantly associated with medication adherence score (β= .016, p < .001, β = .009, p = .033), respectively). Findings suggest that providers seeking to improve medication adherence in older adults, particularly African-American patients, should focus communication on assessing health literacy levels prior to discussing medication instructions.

摘要

健康素养在患者理解其规定药物使用说明方面起着至关重要的作用。为了制定帮助医疗服务提供者以患者易于理解的方式进行沟通的策略,确定健康素养与药物依从性的日常方面之间的关系将是有益的。本研究确定:1)药物依从性方面的健康素养水平差异;2)健康素养与药物依从性之间的关联;以及 3)与药物依从性评分相关的因素。一项便利的、以年龄在 60 岁以上的主要为非裔美国人的老年患者(N=389)为对象的横断面调查,完成了一项问卷调查。卡方分析评估了药物依从性五个方面的健康素养差异。普通线性回归分析确定了与药物依从性评分相关的因素。与具有足够健康素养的患者相比,健康素养有限的患者更有可能忘记服药,更有可能服用少于规定剂量的药物(χ(5)=15.91,p=0.007,χ(5)=10.31,p=0.036)。REALM 评分也与药物依从性评分显著相关(β=0.016,p<.001,β=0.009,p=0.033))。研究结果表明,寻求提高老年患者(特别是非裔美国患者)药物依从性的医疗服务提供者应在讨论药物使用说明之前,将重点放在评估健康素养水平上。

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