Can elderly people take their medicine?

Aging Research Center, Karolinska Institute, Stockholm University, Box 6401, 113 82 Stockholm, Sweden.
Patient Education and Counseling (Impact Factor: 2.2). 12/2005; 59(2):186-91. DOI: 10.1016/j.pec.2004.11.005
Source: PubMed


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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    • "Compliance with a drug regimen is a major problem, particularly for those older people who live alone, are confused, have poor vision, impaired manual dexterity or a failing memory (Ryan, 1999). Studies have shown that older people manage their established medication routines quite well, but introducing a new drug into the regimen or changing a schedule can be problematical, because it is demanding cognitively (Beckman et al., 2005). Other reasons for not following instructions are the extent to which drug regimens interfere with daily life, a lack of understanding or misinterpretation of the instructions, complex drug regimens and forgetfulness (Ryan, 1999). "
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    ABSTRACT: Purpose: The purpose of this paper is to analyse the adoption of a multimodal medication management system (MMS) targeted on older people and home care professionals. The paper aims to describe the expectations of the system and the user experience findings from an empirical qualitative field trial. The field trial results are used to discuss how MMSs should be designed in order to improve adherence to medications. Design/methodology/approach: The paper suggests that building a multimodal medicine management system targeted on both older users and home care professionals brings many benefits over electronic medicine dispenser systems or general reminder systems. The research process uses an iterative prototyping approach including phases of requirements analysis and concept design, prototype building and evaluation in a field trial. Findings: The study demonstrates how a system that merely satisfied users during the prototype building phase does not necessarily succeed as well as expected in the field trials. It would be important to consider reasons for medication non-adherence and non-technology factors influencing willingness to adopt new assistive devices in order to promote diffusion of new MMSs at home. The paper also discusses how the different persuasive functionalities of the system addressed patient-centred factors influencing non-adherence and how they could be addressed. Research limitations/implications: This study has some limitations. The actual adherence to medications was not measured. However, in the future, it will be important to study how the MMSs influence medication adherence. Also, the user experiences of the home care professionals were not studied in the field trials. Home care professionals who were involved in the user studies and trials merely estimated the value for their patients and not for themselves. Originality/value: This paper analyses design issues relevant when designing systems to help older people manage their medications.
    Journal of Assistive Technologies 06/2014; 8(2):2-2. DOI:10.1108/JAT-10-2013-0031
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    • "노인 만성질환자의 경우 계속적인 간호와 건강서비스를 요구하게 되고 치료의 중단은 응급상황을 초래하기 때문에 적절하고 장기적인 관리가 매우 중요하다. 만성질환의 예 방과 관리를 위해 정기적인 건강검진과 복약이행의 준수를 성공적인 치료의 전제조건으로 제시하였고, 노인은 높은 만성질환 이환율과 더불어 건강관리를 위하여 많은 약물을 복용하고 있지만 약물을 사용하는 목적과 방법에 대한 지 식이 부족하다고하여 만성질환 노인에서의 약물치료 중요 성을 강조하였다(Barat, Andreasen, & Damsgaard, 2000; Beckman, Parker, & Thorslund, 2005; Hamilton, 2003 "
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    ABSTRACT: This study was conducted to evaluate the effects of an education program on the knowledge of medication and prevention of depression in the elderly at a local community.
    01/2011; 22(4):399. DOI:10.12799/jkachn.2011.22.4.399
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    • "For 10 instruments the person administering the assessment was not blinded to results of the reference standard and other validation tests (e.g. cognitive function, IADL scores), or this information was not provided [40-45,47,50-52]. In other cases, the rater was blinded to some, but usually not all, patient data [39,46,48,49,56]. "
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    ABSTRACT: Older people are commonly prescribed complex multi-drug regimens while also experiencing declines in the cognitive and physical abilities required for medication management, leading to increased risk of medication errors and need for assisted living. The purpose of this study was to review published instruments designed to assess patients' capacity to self-administer medications. Searches of Medline, EMBASE, CINAHL, PsycINFO, International Pharmaceutical Abstracts, Health and Psychosocial Instruments, Google, and reference lists of identified publications were conducted to identify English-language articles describing development and validation of instruments designed to assess patients' capacity to self-administer medications. Methodological quality of validation studies was rated independently against published criteria by two reviewers and reliability and validity data were reviewed. Thirty-two instruments were identified, of which 14 met pre-defined inclusion criteria. Instruments fell into two categories: those that used patients' own medications as the basis for assessment and those that used a simulated medication regimen. The quality of validation studies was generally low to moderate and few instruments were subjected to reliability testing. Most instruments had some evidence of construct validity, through associations with tests of cognitive function, health literacy, activities of daily living or measures of medication management or adherence. Only one instrument had sensitivity and specificity data with respect to prediction of medication-related outcomes such as adherence to therapy. Only three instruments had validity data from more than one independent research group. A number of performance-based instruments exist to assess patients' capacity to manage their own medications. These may be useful for identifying physical and cognitive barriers to successful medication management, but further studies are needed to determine whether they are able to accurately and reliably predict medication outcomes.
    BMC Geriatrics 02/2009; 9(1):27. DOI:10.1186/1471-2318-9-27 · 1.68 Impact Factor
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