A self medication scheme for elderly patients improves compliance with their medication regimens

Abstract

This study of elderly patients discharged from hospital looked at the effect of a self medication (SM) scheme on compliance with drug regimens. Patients from four medical wards for the elderly were recruited. Those from two wards participated in a SM scheme (18 subjects). Patients from the other wards (15) acted as controls. Two weeks after discharge, compliance was significantly better in the SM group. Only 6 per cent (one patient) made serious errors compared with 47 per cent of controls. After three months only 11 patients in each group remained in the study but compliance in SM patients was still better than in controls. The study highlighted the extremely poor ability of the elderly to manage their medicines at home. This was illustrated by problems cited by patients in the non‐self medicating group.

Hospital inpatient self-administration of medicine programmes: a critical literature review

“…Wood [21] Compliance Significantly fewer patients rated as non-compliant in SAG compared to controls. Controls made more serious errors…”

“…Of the studies subjected to statistical analysis, four reported a significant difference [18,19,21,23]. Although a P value of 0.02 is quoted by D'Altroy et al, it is not clear whether this relates to significance between both groups at all levels of compliance.…”

“…Beardsley et al [19] found significant differences (P < 0.01, t-test) in mean numbers of ''deviation in days'' treatment between the selfadministration group (1.8 days deviation) and controls (3.6 days deviation). Wood et al [21] reported significantly more patients with greater than 15% non-compliance in controls compared to the study group at 2 weeks post-discharge (P < 0.02) and at 3 months post-discharge (P < 0.05 chi-squared and Fisher's exact tests). However, the patient numbers in all groups were small and no significant differences were found between the results for patients with less than 15% non-compliance.…”

“…Two authors [18,19] used ''days deviation'' in therapy as measures and pooled data. The remaining study [21] measured numbers of errors made then calculated an average percentage of noncompliance to assign patients to one of three compliance levels.…”

“…Twelve papers measured the effect on compliance as an outcome [16][17][18][19][20][21][22][23][24][25][26][27]. Nine studies were controlled [17][18][19][20][21][22][23][24][25], two uncontrolled [26,27], and one compared a SAP with a structured teaching programme [16]. All samples were small; the largest [25] contained 178 patients in the experimental arm.…”