Medication management and patient compliance in old age
Year: 2007
Type: dissertation
Study design: Observational Study
Abstract: In old age, many physiological functions decrease and many older people\nalso suffer from multiple chronic conditions. This leads to high drug\nconsumption, but may also impair the ability to manage these medications.\nThe first objective of this thesis was to describe different aspects of\nmedication management (MM) in the elderly, such as opening medicine\ncontainers, tablet swallowing and the cognitive components of MM. A\nsecond objective was to explore the relationships between MM and\nfunctions, demographics and compliance in an elderly population. Thirdly,\nwe wanted to explore what older people do when facing difficulties with\nMM.\n\nFor this thesis, three different populations were used: the Kungsholmen\nproject (paper I and III), the SWEOLD (paper II) and the Swedish National\nstudy on Aging and Care (SNAC) (paper IV). In the first and second\nstudies we used tests of opening of containers and of MM respectively. In\nthe third study data were collected on tablet sizes and volumes and\ncorrelated to age, gender, housing and self-reported ability to swallow\nmedicines. For the fourth study we developed a questionnaire regarding\nseveral aspects of MM and patient compliance, also including questions of\nwhat the elderly do when facing difficulties with MM.\n\nWe found that a large proportion of older people living in the community\nhave difficulties with MM. In the first study this was exemplified by the\nfinding that a fairly large proportion was not able to open three\ndifferent kinds of medicine containers. We also found that, among persons\nthat did not manage to open the containers, a large proportion did not\nreceive help with their own medications. In the second study we found\nthat a test of MM including more cognitively demanding processes of MM,\nwas very difficult to perform without making errors on one item or the\nother. In addition, the results from this test correlated poorly to the\nselfreported ability to manage medications.\n\nIn the third study we looked at self-reported ability to swallow tablets\nin relation to tablet sizes and volumes. The results show that there are\nolder people that do experience difficulties when swallowing medicines\nand that they had a larger volume of tablets than others.\n\nFor the fourth study we used the theoretical framework of the\nInternational classification of functioning, disability and health (ICF).\nThe questionnaire contained questions regarding a number of different\naspects of MM, functions of importance to MM and patient compliance. We\nfound that functions were highly correlated to activities of MM. We also\nfound that functions and activities of MM both separately correlated to\npatient compliance. When asked about strategies when experiencing\ndifficulties with their medications, the elderly in our sample reported\nthat they find ways to manage these difficulties with or without help or\naids of any kind.
Source: Figshare
Author: Anna Beckman Gyllenstrand
Language: English
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1649536277