|
Taiwan, a country now in an aging society, health care of the elderly gets more attention, although a lot of studies on the elderly residents in long-term care facilities, but there are few related articles about common drug problem of the residents in these institutions. The main purpose of this study is to show the prevalence of polypharmacy of the elderly in long-term care facilities in Tainan City and explore some related factors. The total number of the study are 376 people, which obtained from a sample survey of the sociodemographic information, objective physical and mental health, quality of life, and then link their outpatient prescription files to get their medication information during the study period (December 2012 to February 2014). The cases of the study were residents from Ma-miao, Ai-xin, Huai-an, Tsz-an, Sheng-gung nursing homes in Tainan City, who lives more than three months and over 65 years old, the researcher collect the information by himself. Research tools using a structural questionnaire, the questionnaire included: " Barthel scale", " Instrumental activities of daily living scale", " Mini-Mental State Examination", " Geriatric Depression Scale," "Major chronic diseases", "Medication records "and " World Health Organization Quality of Life Taiwan version Questionnaire". The data were analyzed by SPSS Statistics 21.0. 376 valid questionnaires were collected. The results show that the average age is 76.01 ± 8.19 years old, and 376 people suffering from chronic diseases, with an average risk of 4.11 ± 1.77 chronic diseases, of which 86.1% suffering from digestive diseases, 78.7% suffering from central nervous system disorders, 58.5% suffering from heart disease, 57.4% suffering from diabetes. Each person takes average 7.75 kinds of medicine in a day, Barthel scale score is 33.68 ± 5.03, Instrumental activities of daily living scale score is 1.86 ± 1.77, Geriatric Depression Scale scores is 5.72 ± 3.19, Mini-Mental State Examination score is 10.78 ± 4.58, each domain score of quality of life: physiological domain is 19.84 ± 8.33, psychological domain is 18.13 ± 7.49, social domain is 11.95 ± 4.09, environment domain is 29.22 ± 6.26. Multiple regression analysis found the depression status (p = 0.002, Adjusted R2 = 0.935) is an important factor that affecting on the medication. Then found the objective mental state deteriorating through the increase of age, then cause an increase of kinds of medication Prevalence of polypharmacy for elderly residents in long-term care facilities in Tainan city (more than five kinds of medication in a single day) was 79.8%, prevalence of severe polypharmacy (more than 10 kinds of medication in a single day) was 40.1%. The higher chance to get polypharmacy is: the higher age, no religion, less educated, childless, lower monthly income, unmarried, higher dependence on physical functional, those with poor objective mental health status. Because long-term care facilities directly brought insurance cards of the resident in order to bring their drugs back, so mostly are fixed medical treatments. How to reduce polypharmacy, thus reducing risk of polypharmacy, is an important health care system issues. The results of this study is to understand medication circumstances of those residents in the long-term care facilities. The results can help the establishment of medication database , and can be used in teaching, research and planning of the NHIs’ long term care program , and thus can be used as formulation reference of health policy direction.
|