We aimed to clarify the differences in medication self-management for older adults supported by nurses at hospitals and home-visit nursing stations. Methods We conducted a questionnaire survey for nurses working in randomly selected hospitals and home-visit nursing stations. We examined the background of the nurses and the medication self-management of older adults supported by them. We divided the affiliations of nurses into hospital and home groups. Results Data were obtained from the responses of 728 nurses. In older adults, the percentage of age composition between hospital and home groups for those aged ≥85 was 21.5% and 35.8%, the average number of medications taken was 6.6 and 8.4, and the percentage of those using neuropsychiatric medications was 36.0% and 63.3% at hospitals and homes, respectively. Also, no significant difference was observed in the form of medication and the number of times the medication was taken daily. Regarding the medication support system, although, no significant difference was observed in the family support, the support rate from pharmacists was significantly higher in the hospital group.
ConclusionIn older adults supported by home-visit nurses, the age, number of medications taken, and use of neuropsychiatric medications were significantly higher, and the support rate from pharmacists was low. Therefore, medication selfmanagement by older adults at home is more challenging. Home-visit nurses need to work with pharmacists to assess the risk of improper prescription and overdose.
PurposeThis study aims to obtain suggestions on factors affecting the total score of evaluation tools based on the results of pretests for the development of a medication adherence assessment tools focusing on the autonomy of the elderly. Methods A survey using an anonymous self-administered questionnaire was conducted on 30 nurses working at acute hospitals and home-visit nursing stations. Recalling a case of elderly patients aged 65-74 having difficulties in self-management of medications, and another case in which self-management was successful, the subjects were asked to answer the same questions. The survey comprised the personal attributes of the recalled patient and 91 questions regarding autonomous adherence. A t-test or one-way analysis of variance for total scores and background factors was performed.
ResultsBased on the responses of 19 nurses (recovery rate, 63.3%), we obtained data for a total of 38 cases (19 in the difficult group and 19 in the appropriate group). The total medication adherence score significantly reduced with the cognitive function of the elderly. However, it was not associated with gender, age, number and types of medications and doses taken per day, medication management method, and the use of psychiatric and external medications. Conclusion Cognitive function was shown to influence medication adherence. Hence, its utility as a scale to measure management ability based on patient autonomy was shown. Further evaluation of reliability and validity as a medication adherence assessment tool through an expanded survey is needed.
Poster Sessions
This study aimed to define good medication adherence of physicians, pharmacists, nurses, and patients. Methods: Using an interview guide, semi-structured interviews were conducted with four physicians, six pharmacists, six nurses, and two patients. A qualitative analysis method was used to analyze the obtained data. Results: Based on the analysis, results showed that 81 codes were extracted for the entire subjects as recognition of good medication adherence. They were divided into 4 categories, "understanding prescription medications as instructed by medical professionals," "cooperativeness with medical professionals," "autonomous self-medication," and "harmony between taking medication and daily life," and further into 15 subcategories. Nurses were shown to have the highest number of extracted codes. Comparing the results for medical professionals and patients, differences in subcategory and code contents were observed. Conclusion: Good medication adherence is recognized differently by medical professionals and patients. It is important for medical professionals to understand that the recognition of medication adherence differs depending on one's function and to support medication in cooperation with others.
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