Medication management and patient compliance in old age
Author: Beckman Gyllenstrand, Anna
Date: 2007-04-20
Location: Samuelssonsalen, Scheelelaboratoriet, Tomtebodavägen 6, KI Campus Solna
Time: 09.00
Department: Institutionen för neurobiologi, vårdvetenskap och samhälle / Department of Neurobiology, Care Sciences and Society
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thesis.pdf (574.2Kb)
Abstract
In old age, many physiological functions decrease and many older people
also suffer from multiple chronic conditions. This leads to high drug
consumption, but may also impair the ability to manage these medications.
The first objective of this thesis was to describe different aspects of
medication management (MM) in the elderly, such as opening medicine
containers, tablet swallowing and the cognitive components of MM. A
second objective was to explore the relationships between MM and
functions, demographics and compliance in an elderly population. Thirdly,
we wanted to explore what older people do when facing difficulties with
MM.
For this thesis, three different populations were used: the Kungsholmen
project (paper I and III), the SWEOLD (paper II) and the Swedish National
study on Aging and Care (SNAC) (paper IV). In the first and second
studies we used tests of opening of containers and of MM respectively. In
the third study data were collected on tablet sizes and volumes and
correlated to age, gender, housing and self-reported ability to swallow
medicines. For the fourth study we developed a questionnaire regarding
several aspects of MM and patient compliance, also including questions of
what the elderly do when facing difficulties with MM.
We found that a large proportion of older people living in the community
have difficulties with MM. In the first study this was exemplified by the
finding that a fairly large proportion was not able to open three
different kinds of medicine containers. We also found that, among persons
that did not manage to open the containers, a large proportion did not
receive help with their own medications. In the second study we found
that a test of MM including more cognitively demanding processes of MM,
was very difficult to perform without making errors on one item or the
other. In addition, the results from this test correlated poorly to the
selfreported ability to manage medications.
In the third study we looked at self-reported ability to swallow tablets
in relation to tablet sizes and volumes. The results show that there are
older people that do experience difficulties when swallowing medicines
and that they had a larger volume of tablets than others.
For the fourth study we used the theoretical framework of the
International classification of functioning, disability and health (ICF).
The questionnaire contained questions regarding a number of different
aspects of MM, functions of importance to MM and patient compliance. We
found that functions were highly correlated to activities of MM. We also
found that functions and activities of MM both separately correlated to
patient compliance. When asked about strategies when experiencing
difficulties with their medications, the elderly in our sample reported
that they find ways to manage these difficulties with or without help or
aids of any kind.
List of papers:
I. Beckman A, Bernsten C, Parker MG, Thorslund M, Fastbom J (2005). "The difficulty of opening medicine containers in old age: a population-based study" Pharm World Sci 27(5): 393-8
Pubmed
II. Beckman AG, Parker MG, Thorslund M (2005). "Can elderly people take their medicine?" Patient Educ Couns 59(2): 186-91. Epub 2005 Jan 26
Pubmed
III. Beckman Gyllenstrand A, Bernsten C, Thorslund M, Fastbom J (2007). "Tablet size and swallowing in the elderly" (Manuscript)
IV. Beckman Gyllenstrand A, Bernsten C, Fastbom J, Johnell K (2007). "Medication management among the oldest old living in the community." (Manuscript)
I. Beckman A, Bernsten C, Parker MG, Thorslund M, Fastbom J (2005). "The difficulty of opening medicine containers in old age: a population-based study" Pharm World Sci 27(5): 393-8
Pubmed
II. Beckman AG, Parker MG, Thorslund M (2005). "Can elderly people take their medicine?" Patient Educ Couns 59(2): 186-91. Epub 2005 Jan 26
Pubmed
III. Beckman Gyllenstrand A, Bernsten C, Thorslund M, Fastbom J (2007). "Tablet size and swallowing in the elderly" (Manuscript)
IV. Beckman Gyllenstrand A, Bernsten C, Fastbom J, Johnell K (2007). "Medication management among the oldest old living in the community." (Manuscript)
Issue date: 2007-03-30
Rights:
Publication year: 2007
ISBN: 978-91-7357-166-1
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