
노인환자의 복약순응도 현황 및 영향인자 분석
Predictive Factors for Medication Adherence in a Geriatric Assessment Program in Korea
분당서울대학교병원 약제부a, 서울대학교 약학대학b, 분당서울대학교병원 노인의료센터c
Department of Pharmacy, Seoul National University Bundang Hospital 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seoungnam-si, Gyeonggi-do, 13620, Republic of Koreaa
College of Pharmacy, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Koreab
Geriatric Center, Seoul National University Bundang Hospital 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seoungnam-si, Gyeonggi-do, 13620, Republic of Koreac
Correspondence to:Kwang-Il Kim, Tel:031-787-7032, E-mail:kikim907@snubh.org
Revised: March 26, 2018
Accepted: September 14, 2018
J. Kor. Soc. Health-syst. Pharm. 2018; 35(4): 418-429
Published November 30, 2018
https://doi.org/10.32429/jkshp.2018.35.4.004
© The Korean Society of Health-system Pharmacists.
Methods : A retrospective cohort study was performed using electronic medical records of 247 patients from March 1st, 2015 to August 31st, 2015. Medication adherence and the types of non-adherence were also collected. Predictive factors for adherence were evaluated by including factors related to demographics, medications, illness, and patterns of medical usage.
Results : The mean age of the study population was 81.2 years (range 65~98 years) and they were taking 9.7 drugs on an average (SD 5.0 drugs). The overall rate of non-adherence was 34%. About 48% of the patients had any forms of assistance in the medication administration. The most common type of non-adherence was“ self-adjustment”. The multivariate analyses revealed that age (adjusted odds ratio, 0.87 [95% CI, 0.80-0.96]; p< 0.05) and the number of inappropriate medications (adjusted odds ratio, 0.59 [95% CI, 0.40-0.89]; p< 0.05) were strong predictors for non-adherence.
Conclusions : These results indicate that strategic considerations of the predictors of non-adherence should be improved in medication counseling services targeting elderly patients.
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원보
J. Kor. Soc. Health-syst. Pharm. 2018; 35(4): 418-429
Published online November 30, 2018 https://doi.org/10.32429/jkshp.2018.35.4.004
Copyright © The Korean Society of Health-system Pharmacists.
Predictive Factors for Medication Adherence in a Geriatric Assessment Program in Korea
Minso Kima, Nayae Choia, Yewon Suha, Jinyoung Parka, Junghwa Leea, Eunsook Leea, Euni Leeb, Sun-wook Kimc, Kwang-Il Kimc,† and Cheol-Ho Kimc
Department of Pharmacy, Seoul National University Bundang Hospital 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seoungnam-si, Gyeonggi-do, 13620, Republic of Koreaa
College of Pharmacy, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Koreab
Geriatric Center, Seoul National University Bundang Hospital 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seoungnam-si, Gyeonggi-do, 13620, Republic of Koreac
Correspondence to:Kwang-Il Kim, Tel:031-787-7032, E-mail:kikim907@snubh.org
Revised: March 26, 2018
Accepted: September 14, 2018
Abstract
Background : To improve medication adherence in elderly patients, the role of pharmacists in team-based services has been highlighted in the literature. However, not much is known about the role and the service elements involved in comprehensive geriatric programs in South Korea. This study was designed to describe the current status of medication adherence in geriatric patients based on the comprehensive geriatric assessment program and analyze the predictive factors for medication adherence in a tertiary teaching hospital.
Methods : A retrospective cohort study was performed using electronic medical records of 247 patients from March 1st, 2015 to August 31st, 2015. Medication adherence and the types of non-adherence were also collected. Predictive factors for adherence were evaluated by including factors related to demographics, medications, illness, and patterns of medical usage.
Results : The mean age of the study population was 81.2 years (range 65~98 years) and they were taking 9.7 drugs on an average (SD 5.0 drugs). The overall rate of non-adherence was 34%. About 48% of the patients had any forms of assistance in the medication administration. The most common type of non-adherence was“ self-adjustment”. The multivariate analyses revealed that age (adjusted odds ratio, 0.87 [95% CI, 0.80-0.96]; p< 0.05) and the number of inappropriate medications (adjusted odds ratio, 0.59 [95% CI, 0.40-0.89]; p< 0.05) were strong predictors for non-adherence.
Conclusions : These results indicate that strategic considerations of the predictors of non-adherence should be improved in medication counseling services targeting elderly patients.
Keywords: Elderly patient, Medication adherence, Comprehensive geriatric assessment, Predictive factor