Balkrishnan R
Division of Health Policy and Administration, University of North Carolina at Chapel Hill, 27899-7360, USA.
Clin Ther. 1998 Jul-Aug;20(4):764-71. doi: 10.1016/s0149-2918(98)80139-2.
As average life expectancy increases, so do the incidence of chronic diseases and the number of persons receiving long-term drug therapy. Thus elderly patients' noncompliance with medication regimens has the potential for sweeping medical and economic consequences and is likely to become increasingly important in the design of disease-management programs for this population. The author conducted a MEDLINE search of the English-language literature for the years 1962 to 1997 to identify articles concerning predictors of medication compliance in the elderly. A descriptive analysis of this literature indicated that there remains some uncertainty about the reasons for noncompliant medication-taking in the elderly. Clear associations have been established between elderly patients' medication adherence and race, drug and dosage form, number of medications, cost of medications, insurance coverage, and physician-patient communication. However, the findings are inconsistent with regard to the effects of patients' age, sex, socioeconomic status, living arrangement, comorbidities, number of physician visits, and knowledge, attitudes, and beliefs about health. Until the results of further comprehensive studies are available, the current knowledge should be considered when designing and implementing disease-management programs for the elderly.
随着平均预期寿命的增加，慢性病的发病率以及接受长期药物治疗的人数也在上升。因此，老年患者不遵守药物治疗方案可能会产生广泛的医学和经济后果，并且在针对这一人群的疾病管理项目设计中可能会变得越来越重要。作者对1962年至1997年的英文文献进行了MEDLINE检索，以确定有关老年人药物依从性预测因素的文章。对这些文献的描述性分析表明，老年人不遵医嘱服药的原因仍存在一些不确定性。老年患者的药物依从性与种族、药物和剂型、药物数量、药物成本、保险覆盖范围以及医患沟通之间已建立了明确的关联。然而，关于患者年龄、性别、社会经济地位、生活安排、合并症、就诊次数以及对健康的知识、态度和信念的影响，研究结果并不一致。在获得进一步全面研究的结果之前，在为老年人设计和实施疾病管理项目时应考虑当前的知识。
