Speech Science, School of Psychology, The University of Auckland, Tamaki Campus, Private Bag 92019, Auckland, 1142, New Zealand.
Waitemata District Health Board (WDHB), Auckland, New Zealand.
Dysphagia. 2019 Feb;34(1):119-128. doi: 10.1007/s00455-018-9922-7. Epub 2018 Jul 11.
Medicine administration errors are twice as frequent in people with dysphagia than in those without. Medicine administration is particularly critical for people with Parkinson's disease where late, or missed doses reduce medicine effectiveness and impact on the quality of life. The aim of this study was to explore the current medicine administration practices of people with Parkinson's disease in New Zealand. A self-administered online survey was developed by an interprofessional group including people with Parkinson's disease (the primary stakeholders), speech-language pathologists and pharmacists. The survey was administered using a cross-sectional study design and asked respondents about self-reported swallowing difficulties [using Eating Assessment Tool (EAT-10)], medicine regimes and strategies used to swallow medicines. Seventy-one people with Parkinson's disease responded to the survey (69% male, mean age 72 years, mean years with Parkinson's disease 9 years). Respondents reported complex daily multi-medicine consumption (mean no. of pills 11, range 2-25). Analyses showed that 57% of respondents scored outside the normal range for EAT-10 (> 3) with 57% complaining of difficulties with pills. Many respondents admitted to missing medicines and requiring external reminders. Multiple strategies for swallowing pills were described including crushing tablets, using yoghurt or fruit juice, and swallowing strategies (such as head tilt, effortful swallow, chin down and altered pill placement in the mouth). Medicine administration is complex and challenging for people with Parkinson's disease. The development of educational packages for people with Parkinson's disease, their carers and health professionals is much needed.
吞咽困难者的用药错误是无吞咽困难者的两倍。对于帕金森病患者来说，用药管理尤其重要，因为漏服或迟服会降低药物的疗效，影响生活质量。本研究旨在探讨新西兰帕金森病患者的当前用药管理实践。一个由跨专业团队（包括帕金森病患者（主要利益相关者）、言语语言病理学家和药剂师）开发的自我管理在线调查。该调查采用横断面研究设计，询问受访者有关自我报告的吞咽困难（使用饮食评估工具[EAT-10]）、用药方案以及吞咽药物时使用的策略。71 名帕金森病患者对该调查做出了回应（69%为男性，平均年龄 72 岁，帕金森病平均患病年限为 9 年）。受访者报告称他们每天需要服用复杂的多种药物（平均药丸数为 11 粒，范围 2-25 粒）。分析显示，57%的受访者 EAT-10 评分超出正常范围（>3），57%的受访者抱怨吞咽药片有困难。许多受访者承认漏服药物并需要外部提醒。描述了多种吞咽药片的策略，包括压碎药片、使用酸奶或果汁，以及吞咽策略（如头倾斜、用力吞咽、下巴向下和改变药丸在口中的位置）。对于帕金森病患者来说，用药管理既复杂又具有挑战性。非常需要为帕金森病患者、他们的照顾者和卫生专业人员开发教育包。
