Centre for Medicines Optimisation Research and Education, UCLH NHS Foundation Trust and UCL School of Pharmacy, London, UK.
Department of Clinical Pharmaceutical and Biological Sciences, University of Hertfordshire, Hatfield, UK.
Int J Pharm Pract. 2022 Jan 7;30(1):67-74. doi: 10.1093/ijpp/riab077.
Medicines acceptability is likely to have a significant impact on older people's adherence and, consequently, treatment effectiveness. The objective was to explore the influence of setting on medicines acceptability in older people.
A multi-centre, prospective, cross-sectional, observational study was conducted in one care home and one elderly care hospital ward in London, UK, involving individuals on ≥1 medicine(s) and aged ≥65 years. Data-driven approach was applied using multiple observer-reported outcomes analysis tool to distinguish between positively and negatively accepted medicines.
263 observer reports from the care home (n = 97) and hospital ward (n = 166) involving 155 distinct medicinal products were assessed. Collectively, medicines appeared better accepted by patients at the hospital. Differences appeared to be driven by variations in solid oral dosage form (SODF) acceptability. Patients with dysphagia poorly accepted medicines in both settings, as expected. SODFs were unexpectedly better accepted in the hospital than in the care home in patients without dysphagia.
Medicines acceptability was affected by patient's characteristics, dosage form type and setting. Changes in care practices between care home and hospital may affect medicine administration and lead to variations in the ability and willingness of patients and carers to use the product as intended.
药物可接受性可能对老年人的依从性产生重大影响，进而影响治疗效果。本研究旨在探讨环境对老年人药物可接受性的影响。
在英国伦敦的一家养老院和一家老年护理医院进行了一项多中心、前瞻性、横断面、观察性研究，纳入了≥1 种药物且年龄≥65 岁的患者。采用数据驱动的方法，使用多种观察者报告的结局分析工具，区分正面和负面接受的药物。
对养老院（n=97）和医院病房（n=166）的 263 名观察者报告，涉及 155 种不同的药物进行了评估。总体而言，医院的患者对药物的接受度更高。这种差异似乎是由固体制剂（SODF）接受度的差异驱动的。预期吞咽困难的患者在两个环境中都难以接受药物，而在没有吞咽困难的患者中，SODF 在医院的接受度出乎意料地高于养老院。
药物可接受性受患者特征、剂型类型和环境的影响。养老院和医院之间护理实践的变化可能会影响药物的管理，并导致患者和护理者使用产品的能力和意愿出现差异。
