老年共病患者服药依从性及其影响因素研究

Background??As the aging population continues to increasethere has been a rise in the prevalence of multimorbidity in the elderly. The adherence to medication regimens by elderly patients with multimorbidity significantly impacts the effectiveness of chronic disease management. Objective??This study analyses the factors that impact medication adherence among the elderly with multimorbidity in Guangdong province. This study aims to provide a foundation for the management of multimorbidity in this population. Methods ?A multi-stage stratified cluster random sampling method was used to survey a population of 998 multimorbid patients aged 60 years and above in Guangdong province. Medication adherence was the dependent variablewhile patient sexagemarital statusliving conditionseducation levelpersonal annual incomefamily encouragement for medication adherencefamily doctor supportnumber of diseasesdisease awarenessmedication awarenessbody mass indexBMIsmoking and alcohol consumption were considered as independent variables. Multiple Logistic regression analysis was used to identify the factors influencing medication adherence among elderly patients with multimorbidity in Guangdong Province. Results??A total of 1000 questionnaires were distributed and 998 valid questionnaires were collectedwith a valid recovery rate of 99.8%. Among the 998 cases of elderly patients with multimorbidity in Guangdong Provincethere were 719 cases72.0%with good adherence to medication and 279 cases28.0%with poor medication adherencethere were 512 cases51.3%of males and 486 cases48.7%of females. The results of multifactorial logistic regression analysis showed thateducation level high school/secondary schoolOR=0.29895%CI=0.117~0.762college and aboveOR=0.32595%CI=0.127~0.831personal annual income >30 000~50 000 RMBOR=7.69495%CI=2.071~28.582>50 000 to 100 000 RMBOR=12.40895%CI=3.22947.686>100 000 RMB to 200000 RMBOR=4.89395%CI=1.174~20.397and frequency of family members'?supervision of medication taking occasionallyOR=1.84295%CI=1.222~2.779family doctor's help slightly helpfulOR=2.53795%CI=1.531~4.205understanding of the condition mostly understoodOR=3.01595%CI=1.948~4.667better understoodOR=3.51095%CI=1.955~6.300some/no understandingOR=3.46995%CI=1.338~8.994medication concern mostly concernedOR=4.92895%CI=3.336~7.278more concernedOR=3.67095%CI=1.915~7.033somewhat concerned/unconcernedOR=8.56095%CI=2.497~29.33BMI too lowOR=2.30395%CI=1.154~4.598overweight/obeseOR=0.59895%CI=0.390~0.915and alcohol consumption OR=1.95995%CI=1.270~3.022 were the influencing factors of medication adherence among elderly patients with multimorbidity in Guangdong provinceP<0.05. Conclusion ?The elderly patients with multimorbidity in Guangdong province had better medication adherenceat 72.0%. The elderly patients with multimorbidity in Guangdong province with a high school education and abovelow-income groupfrequently urged to take medication by their family memberswith a lot of help from their family doctorswith a good understanding of their conditionwith a lot of concern about medicationoverweight/obeseand not drinking alcohol had better adherence to their medication. On the other handmedication adherence was poorer among the elderly patients with multimorbidity in Guangdong province who were high-income earnersoccasionally urged to take medication by their family membersslightly assisted by their family doctorshad a low understanding of their conditionpaid little attention to the use of medicationhad a low BMIand drank alcohol.All parties in society should join hands to take multiple measures to improve the medication adherence of elderly patients with multimorbidity in all aspectsstrengthen the integrated management of multimorbidityand promote the health of elderly patients.