老年慢性病患者轻度认知障碍与用药依从性之间的关联
The Association Between Mild Cognitive Impairment and Medication Non-adherence Among Elderly Patients With Chronic Diseases.
作者信息
He Xiaoqin, Wang Xinguo, Wang Bin, Zhu Aiyong
机构信息
School of Graduate, Shanghai University of Traditional Chinese Medicine, Shanghai, CHN.
School of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, CHN.
出版信息
Cureus. 2023 Oct 26;15(10):e47756. doi: 10.7759/cureus.47756. eCollection 2023 Oct.
BACKGROUND
Medication adherence is essential for optimizing treatment outcomes in elderly patients who frequently contend with multiple chronic diseases requiring pharmacological interventions. Mild cognitive impairment (MCI) is a prevalent cognitive disorder among the elderly population, but its impact on medication adherence among elderly patients is still uncertain. This cross-sectional study aimed to investigate the impact of MCI on medication adherence among elderly patients.
METHODS
A cross-sectional study of 436 elderly patients with common chronic diseases aged 60 years and above was conducted. Medication adherence was measured using the Morisky Medication Adherence Scale-8 (MMAS-8). MCI was screened, and cognitive status was assessed using the Mini-Mental State Examination (MMSE) questionnaire. Multivariate logistic regression analysis was performed to identify independent risk factors of medication non-adherence.
RESULTS
Among these elderly patients, 212 (48.6%) had poor medication compliance, and 181 (41.5%) had MCI. Preliminary analyses showed a significant association between MCI and medication non-adherence among elderly patients (odds ratio (OR)=3.95, 95% confidence interval (95%CI)=2.63-5.92, P<0.001). Multivariate logistic regression analysis showed that MCI was independently associated with the risk of medication non-adherence among elderly patients (adjusted OR=2.64, 95%CI=1.64-4.24, P<0.001). Additionally, adverse drug reaction and poor evaluation of medication effects were also independently associated with medication non-adherence in elderly patients (P<0.05).
CONCLUSION
Findings from this cross-sectional study proved the substantial adverse impact of MCI on medication adherence among elderly patients, and MCI was an independently influential factor of medication non-adherence. Identifying the MCI status early and providing interventions to enhance medication adherence are undoubtedly essential for optimizing healthcare outcomes in elderly patients.
背景
药物依从性对于优化老年患者的治疗效果至关重要，这些患者经常患有多种需要药物干预的慢性疾病。轻度认知障碍（MCI）是老年人群中普遍存在的认知障碍，但其对老年患者药物依从性的影响仍不确定。本横断面研究旨在调查MCI对老年患者药物依从性的影响。
方法
对436名60岁及以上患有常见慢性疾病的老年患者进行了横断面研究。使用Morisky药物依从性量表8（MMAS-8）测量药物依从性。筛查MCI，并使用简易精神状态检查表（MMSE）问卷评估认知状态。进行多变量逻辑回归分析以确定药物不依从的独立危险因素。
结果
在这些老年患者中，212名（48.6%）药物依从性差，181名（41.5%）患有MCI。初步分析显示，老年患者中MCI与药物不依从之间存在显著关联（优势比（OR）=3.95，95%置信区间（95%CI）=2.63-5.92，P<0.001）。多变量逻辑回归分析显示，MCI与老年患者药物不依从风险独立相关（调整后的OR=2.64，95%CI=1.64-4.24，P<0.001）。此外，药物不良反应和对药物效果的不良评价也与老年患者的药物不依从独立相关（P<0.05）。
结论
本横断面研究的结果证明了MCI对老年患者药物依从性有重大不利影响，且MCI是药物不依从的一个独立影响因素。早期识别MCI状态并提供干预措施以提高药物依从性，无疑对于优化老年患者的医疗保健结果至关重要。
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