Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.
Department of Pharmacy, University of Oslo, Oslo, Norway.
JMIR Aging. 2024 Oct 4;7:e57651. doi: 10.2196/57651.
Multidose drug dispensing (MDD) is an adherence aid where medicines are machine-dispensed in disposable unit bags, usually for a 14-day period. MDD replaces manually filled dosettes in many home care services in Norway. While evidence suggests that MDD can improve medication adherence and reduce errors, there are few studies on how patients manage MDD at home and how this affects their daily routines.
The aim of the study is to identify factors influencing medication self-management behavior among MDD users living at home and explore how MDD affects medication self-management.
We conducted semistructured interviews with 19 MDD users in Oslo between August 2019 and February 2020. The interviews were held at the participants' homes, and the interview transcripts were analyzed thematically.
All participants in the study received some form of assistance with medication management from home care services. This assistance ranged from MDD delivery every other week to actual assistance with medication administration multiple times daily. However, regardless of the level of assistance received, participants primarily managed their MDD medications themselves. Daily medication routines and knowledge about medicines varied among the participants, with some taking an active role in their medication management, while others relied on others to take responsibility. The degree of involvement seemed determined by motivation rather than capability.
MDD can support medication self-management, but its effectiveness varies among patients. The level of medication management by MDD users is not solely determined by their actual capabilities. Factors such as interest in self-care and independence, available support, information, and cognitive capacity all play a role in determining the degree of autonomy.
多剂量药物配给（MDD）是一种依从性辅助工具，通过机器将药物分装在一次性单位袋中，通常为 14 天的用量。MDD 在挪威的许多家庭护理服务中取代了手动填充的药盒。虽然有证据表明 MDD 可以提高药物依从性并减少错误，但关于患者如何在家中管理 MDD 以及这如何影响他们的日常生活的研究甚少。
本研究旨在确定影响在家中使用 MDD 的患者药物自我管理行为的因素，并探讨 MDD 如何影响药物自我管理。
我们于 2019 年 8 月至 2020 年 2 月在奥斯陆对 19 名 MDD 用户进行了半结构式访谈。访谈在参与者家中进行，对访谈记录进行了主题分析。
研究中的所有参与者都从家庭护理服务中获得某种形式的药物管理协助。这种协助范围从每隔一周配送 MDD 到每天实际协助多次药物管理。然而，无论接受的协助程度如何，参与者主要还是自己管理 MDD 药物。日常用药程序和对药物的了解因人而异，一些人积极参与药物管理，而另一些人则依赖他人负责。参与程度似乎取决于动机而非能力。
MDD 可以支持药物自我管理，但对患者的效果因人而异。MDD 用户的药物管理水平不仅仅取决于他们的实际能力。对自我护理和独立性的兴趣、可用的支持、信息和认知能力等因素都在决定自主程度方面发挥作用。
