居家老年人群的药物管理模式及相关医疗临床特征:葡萄牙中部的一项横断面研究。

Patterns of Medication Management and Associated Medical and Clinical Features among Home-Dwelling Older Adults: A Cross-Sectional Study in Central Portugal.

机构信息

Center for Innovative Care and Health Technology, Polytechnic of Leiria, 2411-901 Leiria, Portugal.

School of Health Sciences, Polytechnic of Leiria, 2411-901 Leiria, Portugal.

出版信息

Int J Environ Res Public Health. 2023 Jan 17;20(3):1701. doi: 10.3390/ijerph20031701.

Abstract

Ageing is frequently associated with multimorbidity and polypharmacy. The present study aimed to identify the current medication management patterns and the profiles of home-dwelling older adults and to find any association with their conditions, including frailty and cognitive impairment. Within the scope of this cross-sectional study, 112 older adults living in the community were assessed via face-to-face structured interviews. Frailty, cognitive status, medication management and clinical and sociodemographic variables were evaluated. Descriptive and inferential statistics were calculated. The mean participant age was 76.6 ± 7.1 years, 53.6% of participants were women, and 40.2% of participants lived alone. More than half were classified as having frailty (58.9%), almost one-fifth (19.6%) presented with a moderate cognitive impairment had more than one disease, and 60.7% were polymedicated. No associations were found between polymedication and medication self-management, the use of over-the-counter medications, living alone, having a poor understanding of pharmacological therapy and/or pathology, or having more than one prescriber. Self-management was associated with age, the number of medications, frailty and cognitive status. Binary logistic regressions showed that cognitive impairment had statistically significant differences with medication management, having a poor understanding of pharmacological therapy and/or pathology, having one prescriber and the use of medications not prescribed by physicians. Interventions to prevent medication-related problems in home-dwelling older adults are recommended.

摘要

衰老通常与多种疾病和多种药物治疗有关。本研究旨在确定当前居家老年人群的药物管理模式和特征,并发现其与身体虚弱和认知障碍等状况之间的任何关联。在这项横断面研究中,通过面对面的结构化访谈评估了 112 名居住在社区中的老年人。评估了身体虚弱、认知状态、药物管理以及临床和社会人口统计学变量。计算了描述性和推断性统计数据。参与者的平均年龄为 76.6±7.1 岁,53.6%的参与者为女性,40.2%的参与者独居。超过一半的人被归类为身体虚弱(58.9%),近五分之一(19.6%)的人有中度认知障碍,有超过一种疾病,60.7%的人同时使用多种药物。药物自我管理、使用非处方药物、独居、对药物治疗和/或病理学理解差、有不止一位开处方者等因素与药物多种治疗之间均无关联。自我管理与年龄、用药数量、身体虚弱和认知状态有关。二元逻辑回归显示,认知障碍与药物管理、对药物治疗和/或病理学理解差、只有一位开处方者以及使用未经医生开具的药物有统计学上的显著差异。建议针对居家老年人群开展预防与药物相关问题的干预措施。

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