Department of Natural Sciences, Medicine Course, State University of Southwest Bahia, Vitória da Conquista, Bahia, Brazil.
Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil.
J Eval Clin Pract. 2021 Aug;27(4):817-825. doi: 10.1111/jep.13480. Epub 2020 Sep 10.
RATIONALE, AIMS, AND OBJECTIVES: Misunderstanding medication dosage regimen instructions can lead to unintentional misuse of a prescribed medicine, non-adherence to providers' instructions, and other treatment-related issues. We aimed to evaluate the frequency of and factors associated with older patients' misunderstanding of medication dosage regimen instructions after consultation with a general practitioner.
This cross-sectional study was conducted in 22 primary-care facilities in Brazil. Data were collected from September 2016 to December 2017 using a multidimensional questionnaire. Patients who were 60 years old or older who visited primary care units were included in the study (n = 416).
Of the older patients interviewed, 38.2% had a misunderstanding of medication dosage regimen instructions; being female was a protective factor against the misunderstanding of medication dosage regimen instructions (prevalence ratio [PR] = 0.63; 95% confidence interval [CI] = 0.45-0.89). In relation to other factors with an important association, misunderstanding medication dosage regimen instructions was 71% higher among illiterate participants (PR = 1.71; 95% CI = 1.25-2.35), 39% higher among people who considered their memory to be poor (PR = 1.39; 95% CI = 1.01-1.91), 49% higher in those who did not have a job at the time of the interview (PR = 1.49; 95% CI = 1.01-2.19), and 50% higher in patients who had been prescribed five or more medications (PR = 1.50; 95% CI = 1.02-2.20).
The results showed that older people's misunderstandings of medication dosage regimen instructions after consultation with a general practitioner was greater than expected due to a range of factors, especially polypharmacy, poor literacy, poor memory, and having a job at the time of the interview. Health services and professionals should implement strategies to increase the quality of the guidance given to elderly individuals and to ensure their adherence to the regimen instructions of their medications.
背景、目的和目标：对药物剂量方案说明的误解可能导致无意中误用处方药物、不遵守提供者的指示以及其他与治疗相关的问题。我们旨在评估老年患者在与全科医生就诊后对药物剂量方案说明误解的频率和相关因素。
本横断面研究在巴西的 22 个基层医疗设施中进行。数据于 2016 年 9 月至 2017 年 12 月期间使用多维问卷收集。研究纳入了 60 岁或以上到基层医疗单位就诊的患者（n=416）。
在接受访谈的老年患者中，有 38.2%对药物剂量方案说明存在误解；女性是对药物剂量方案说明误解的保护因素（流行率比 [PR] = 0.63；95%置信区间 [CI] = 0.45-0.89）。与其他具有重要关联的因素相关，不识字的参与者对药物剂量方案说明的误解率高 71%（PR=1.71；95%CI=1.25-2.35），认为自己记忆力差的参与者高 39%（PR=1.39；95%CI=1.01-1.91），当时没有工作的参与者高 49%（PR=1.49；95%CI=1.01-2.19），当时开了 5 种或更多药物的患者高 50%（PR=1.50；95%CI=1.02-2.20）。
结果表明，由于一系列因素，特别是多种药物治疗、文化程度低、记忆力差和就诊时工作，老年患者在与全科医生就诊后对药物剂量方案说明的误解程度高于预期。卫生服务和专业人员应实施策略，提高对老年人的指导质量，并确保他们遵守药物剂量方案说明。
