Can elderly people take their medicine?
ABSTRACT This study used performance tests to assess the cognitive, visual and physical abilities related to taking medicines in the elderly population. The study population consisted of the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD II), a nationally representative interview survey. SWEOLD II is a random sample of all community-based and institutionalized persons aged 77+ in Sweden. Five tests related to medication management were administered in the direct interviews (n=492): hand function (opening bottle), vision (reading label), and medication competence (comprehension and calculation). Results showed that 9.4% could not read instructions on a medicine container and 14.6% had difficulty opening a plastic flip-top medicine bottle. The three cognitive tests related to taking medicine resulted in 30.7, 47.4 and 20.1% errors. Combining all the tests revealed that 66.3% of the sample had at least one limitation of capacity related to taking medicine. There were no significant gender differences. Among those people who did not pass all the tests, 31.8% lived alone with no home-help. Taking medicines is a complex task and a large proportion of the Swedish elderly population has cognitive, visual or physical limitations that may hinder their ability to take medicines accurately. Awareness of these limitations is essential to concordance.
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ABSTRACT: Background Geriatric assessments are established tools in institutional care since they enable standardized detection of relevant age-related disorders. Geriatric assessments could also be helpful in general practice. However, they are infrequently used in this setting, mainly due to their lengthy administration. The aim of the study was the development of a ¿manageable geriatric assessment ¿ MAGIC¿, specially tailored to the requirements of daily primary care.MethodsMAGIC was developed based on the comprehensive Standardized Assessment for Elderly People in Primary Care (STEP), using four different methodological approaches: We relied on A) the results of the PRISCUS study by assessing the prevalence of health problems uncovered by STEP, the importance of the respective problems rated by patients and general practitioners, as well as the treatment procedures initiated subsequently to the assessment. Moreover, we included findings of B) a literature analysis C) a review of the STEP assessment by experienced general practitioners and D) focus groups with general practitioners.ResultsThe newly created MAGIC assessment consists of 9 items and covers typical geriatric health problems and syndromes: function, falls, incontinence, cognitive impairment, impaired ears and eyes, vaccine coverage, emotional instability, and isolation.ConclusionsMAGIC promises to be a helpful screening instrument in primary care consultations involving elderly multimorbid patients. Applicable within a minimum of time it still covers health problems highly relevant with regard to a potential loss of autonomy. Feasibility will be tested in the context of a large, still ongoing randomized controlled trial on ¿reduction of potentially inadequate medication in elderly patients¿ (RIME study; DRKS-ID: DRKS00003610) in general practice.BMC Family Practice 01/2015; 16(1):4. DOI:10.1186/s12875-014-0215-4 · 1.74 Impact Factor
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ABSTRACT: L’observance thérapeutique peut être définie comme le degré d’adéquation entre le comportement du patient et les recommandations de son médecin. On estime que 50 % des patients porteurs de maladies chroniques sont insuffisamment observants. Ce phénomène, difficile à évaluer, a cependant des conséquences médicales et économiques considérables. La compréhension de l’(in)observance nécessite une approche multifactorielle, intégrant à la fois des facteurs biomédicaux, psychosociaux et environnementaux. La prise en compte de ces déterminants doit permettre la mise en place d’interventions visant à améliorer l’adhésion thérapeutique. Mais la mauvaise observance est aussi le reflet d’une relation médecin–malade en pleine évolution, où les thérapeutiques autrefois imposées nécessitent aujourd’hui la pleine adhésion du patient.Medecine et Longevite 12/2012; 4(3-4):111-122. DOI:10.1016/j.mlong.2012.09.001