Ruscin J M, Semla T P
School of Pharmacy, University of Colorado Health Sciences Center, Denver 80262, USA.
Ann Pharmacother. 1996 Oct;30(10):1083-8. doi: 10.1177/106002809603001003.
To identify risk factors for poor medication management skills in community-dwelling older adults by using a performance-based medication management assessment instrument.
A cross-sectional investigation.
A university outpatient geriatric assessment clinic.
Fifty-nine community-dwelling older adults aged 62-102 years.
Patients were assessed on their ability to perform medication management tasks, including reading prescription labels, interpreting medication instructions, opening safety-capped vials, removing tablets from vials, and differentiating tablet colors. The Mini-Mental State Examination (MMSE) was administered and the Katz index of activities of daily living was obtained during the same clinic visit.
Cognitive impairment (MMSE < 24) and physical dependency (Katz > or = 1) were both found to be risk factors for the inability to perform individual tasks and independent risk factors for poor overall outcome on the medication management assessment, odds ratios (95% confidence interval) 9.39 (7.82 to 10.96) and 7.24 (5.60 to 8.88), respectively. Age, gender, education, or number of prescription medications were not associated with the ability to perform individual tasks or to overall outcome on the medication management assessment.
Cognitive deficits and physical dependency appear to be strong predictors for the inability to perform tasks associated with medication management. Assessment of medication management skills in older adults living in the community may help identify specific problems, aid in planning patient care, and promote independence.
通过使用基于表现的药物管理评估工具，确定社区居住的老年人药物管理技能差的风险因素。
横断面调查。
大学门诊老年评估诊所。
59名年龄在62 - 102岁的社区居住老年人。
评估患者执行药物管理任务的能力，包括阅读处方标签、解读用药说明、打开安全瓶盖药瓶、从药瓶中取出药片以及区分药片颜色。在同一次门诊就诊期间进行简易精神状态检查（MMSE）并获取日常生活活动能力的Katz指数。
认知障碍（MMSE < 24）和身体依赖（Katz≥1）均被发现是无法完成个体任务的风险因素，以及药物管理评估中总体结果不佳的独立风险因素，优势比（95%置信区间）分别为9.39（7.82至10.96）和7.24（5.60至8.88）。年龄、性别、教育程度或处方药数量与执行个体任务的能力或药物管理评估的总体结果无关。
认知缺陷和身体依赖似乎是无法完成与药物管理相关任务的有力预测因素。对社区居住老年人的药物管理技能进行评估可能有助于识别具体问题、协助规划患者护理并促进独立性。
