Article

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

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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    • "However, both problems are often unrecognized and untreated, though they are correlated with a variety of adverse effects. For visual impairment, an increased mortality risk and additional decrease in quality of life as well as increases in falls, medication noncompliance, automobile accidents, and hip fractures have been demonstrated454647484950. Likewise, hearing loss is linked to detrimental effects as it is known to be associated with social isolation, functional decline, decreased quality of life, depressive symptoms, and cognitive deficits[51]. "
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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.
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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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    • "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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