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患有多种疾病的老年人的药物依从性及相关决定因素:一项横断面研究。

Medication adherence and related determinants in older people with multimorbidity: A cross-sectional study.

机构信息

Nursing Research, Innovation and Development Center of Lisbon (CIDNUR), Nursing School of Lisbon, Lisbon, Portugal.

Institute of Environmental Health (ISAMB), Faculty of Medicine, University of Lisbon, Lisbon, Portugal.

出版信息

Nurs Forum. 2021 Oct;56(4):834-843. doi: 10.1111/nuf.12619. Epub 2021 Jun 1.

Abstract

AIM

Identify the medication adherence determinants in older adults with multimorbidity and polypharmacy.

MATERIALS AND METHODS

A cross-sectional study was conducted in a non-probabilistic sample of 245 adults ≥65 years recruited in a general medical ward of one teaching hospital. Data were collected during hospital stay using a face-to-face interview based on a set of validated questionnaires, such as the measure treatment adherence, the beliefs about medicines questionnaire-specific and the geriatric depression scale. Descriptive and multiple linear regression analysis were performed.

RESULTS

Participants' mean age was 78.32 (SD: 6.95) years and 50.6% were women. Older adults lived with an average of 7.51 (SD: 1.95) chronic conditions and had a mean of 7.95 (min. 4; max. 18) medications prescribed. The proportion of older adults adherent to medication was 43.7%. Depression (  = -0.142; p = 0.031), beliefs about treatment necessity (  = 0.306; p = 0.001) and concerns about the medication (  = -0.204; p = 0.001) were found as independent determinants of adherence.

CONCLUSION

Self-reported medication non-adherence appears to be common in older adults with multimorbidity and polypharmacy. Depression, necessity and concerns should be considered when assessing medication non-adherence in practice. This study will also contribute to develop an intervention to manage adherence in older people, as part of a doctoral research project.

摘要

目的

确定患有多种疾病和多种药物治疗的老年患者药物依从性的决定因素。

材料和方法

这是一项横断面研究,在一家教学医院的普通内科病房,以非概率抽样的方式招募了 245 名年龄≥65 岁的成年人。在住院期间,通过面对面访谈收集数据,访谈基于一套经过验证的问卷,如治疗依从性量表、药物信念问卷和老年抑郁量表。进行描述性和多元线性回归分析。

结果

参与者的平均年龄为 78.32(标准差:6.95)岁,其中 50.6%为女性。老年人平均患有 7.51(标准差:1.95)种慢性疾病,平均开处 7.95(最少 4;最多 18)种药物。药物依从性的老年人比例为 43.7%。抑郁(  = -0.142;p = 0.031)、对治疗必要性的信念(  = 0.306;p = 0.001)和对药物的担忧(  = -0.204;p = 0.001)被认为是依从性的独立决定因素。

结论

自我报告的药物不依从在患有多种疾病和多种药物治疗的老年患者中似乎很常见。在实践中评估药物不依从时,应考虑抑郁、必要性和担忧。这项研究也将有助于为老年人管理依从性制定一项干预措施,作为博士研究项目的一部分。

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