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基层医疗中老年人的用药问题及影响因素

Medication use problems and factors affecting older adults in primary healthcare.

作者信息

Christopher Christina Malini, Blebil Ali Qais, Bhuvan K C, Alex Deepa, Mohamed Ibrahim Mohamed Izham, Ismail Norhasimah, Cheong Wing Loong Mark

机构信息

School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Subang Jaya, Selangor, Malaysia.

School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Subang Jaya, Selangor, Malaysia; Department of Pharmacy, Al Rafidain University College, Baghdad, Iraq.

出版信息

Res Social Adm Pharm. 2023 Dec;19(12):1520-1530. doi: 10.1016/j.sapharm.2023.08.001. Epub 2023 Aug 9.

Abstract

BACKGROUND

As the largest demographic group utilizing primary healthcare facilities, older adults often face the challenge of managing multiple chronic illnesses, leading to numerous medications.

OBJECTIVE

The present study aims to assess medication use problems among older adults and explore the factors affecting them in primary healthcare settings.

METHODS

A mixed-method study was conducted to establish a baseline understanding of the perspectives and challenges faced by older adults, with regards to medication use. Translated Medication Use Questionnaire (MedUseQ), a patient-centered tool, was distributed to older adults above 60 in primary healthcare settings to assess their frequency of problems related to medication use. Fifteen semi-structured interviews were conducted to explore this topic in depth. Descriptive and inferential analyses were conducted with quantitative data. Interviews were transcribed verbatim, and thematic analysis was conducted. Quantitative and qualitative findings data were triangulated.

RESULTS

The study involved 393 participants. The most common problems with regards to medication use were polypharmacy (55.4%), administration difficulties (48.4%), limited awareness about adverse drug events (47.3%), issues with adherence (46.5%), and accessibility to primary healthcare (42.7%). Approximately 55% were satisfied with the older adult-centered medication use services by pharmacist and doctors. The qualitative findings showed that major factors affecting medication use were forgetfulness, language barriers, lack of awareness, transportation problems, long waiting times, and multiple visits to healthcare facilities.

CONCLUSION

The findings of this study reveal that a significant proportion, around 50%, of the older adult population face challenges with medication use in Penang. These difficulties mainly stem from medication administration, adherence, accessibility, polypharmacy, and inadequate medication knowledge. The qualitative analysis further highlighted several factors that contribute to such medication-related problems. Given the rapidly aging Association of Southeast Asian Nations (ASEAN) population, it is essential to devise effective solutions and strategies to tackle medication use-related issues among older adults.

摘要

背景

作为利用初级医疗保健设施的最大人口群体,老年人常常面临管理多种慢性疾病的挑战,这导致了大量用药。

目的

本研究旨在评估老年人在初级医疗保健环境中的用药问题,并探讨影响这些问题的因素。

方法

开展了一项混合方法研究,以初步了解老年人在用药方面的观点和面临的挑战。向初级医疗保健机构中60岁以上的老年人发放了以患者为中心的翻译版《用药调查问卷》(MedUseQ),以评估他们用药相关问题的发生频率。进行了15次半结构化访谈以深入探讨该主题。对定量数据进行了描述性和推断性分析。访谈内容逐字转录,并进行了主题分析。对定量和定性研究结果数据进行了三角互证。

结果

该研究涉及393名参与者。用药方面最常见的问题是多重用药(55.4%)、给药困难(48.4%)、对药物不良事件的认识有限(47.3%)、依从性问题(46.5%)以及获得初级医疗保健服务的便利性(42.7%)。约55%的人对药剂师和医生提供的以老年人为中心的用药服务感到满意。定性研究结果表明,影响用药的主要因素包括健忘、语言障碍、缺乏认识、交通问题、等待时间长以及多次前往医疗机构就诊。

结论

本研究结果显示,槟城约50%的老年人群体在用药方面面临挑战。这些困难主要源于药物给药、依从性、可及性、多重用药以及用药知识不足。定性分析进一步突出了导致此类用药相关问题的若干因素。鉴于东南亚国家联盟(东盟)人口迅速老龄化,制定有效解决方案和策略以解决老年人用药相关问题至关重要。

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