Zhongguo quanke yixue (Sep 2024)
The Influence of Rational Drug Use Management Mode of the Elderly in Community on Patients' Knowledge, Attitude and Practice of Drug Use
Abstract
Background With the acceleration of population aging, the problem of multi-drug comorbidity among the elderly is serious, and community health service centers have become an important way for the elderly to obtain various health services. However, the management of medication for elderly patients in primary health care institutions is still in a weak state. Objective To explore the influence of the rational medication management model on patients' knowledge, belief and behavior of medication in the community elderly, and to provide a realistic basis for improving the medication behavior of the elderly. Methods From September to December 2021, two community health centers in Jinshan District, Shanghai were selected as the sample source, elderly patients with chronic disease comorbidity with contracted general practitioner were studied. The contracted elderly patients from one of the community health service centers were randomly selected as the intervention group (n=223), and the contracted elderly patients from another community health service center were selected as the control group (n=198). Baseline matching between groups was performed using a propensity matching score (PSM) in a 1∶1 ratio. Patients in the control group adopted the conventional chronic disease management plan, patients in the intervention group were medication-integrated and instructed to use the Health Care Handbook of Medication for the Elderly and split pill boxes during medication administration, implementing a rational drug use management mode of the elderly in community. The patients' medication knowledge, belief and behavior scores and standardized medication use behaviors at enrollment and after 3 months of follow-up were recorded, and changes before and after the intervention were analyzed. Results After PSM, a total of 141 pairs were successfully matched, and the difference between the basic situation of the intervention group and the control group after matching was not statistically significant (P>0.05). After the intervention, the difference between the patients' knowledge of rational medication, belief, medication adherence score, and the development of standardized medication habits in the intervention group was statistically significant compared with the pre-intervention situation (P<0.05). After the intervention, the patient's knowledge of rational medication use, belief, and medication adherence scoreswere higher than those of the control group in the intervention group. Knowledge of rational medication, belief, and medication adherence scorewere higher than those in the control group, and the difference was statistically significant (P<0.05). After the intervention, the proportion of patients in the intervention group who established the habit of reminding medication, placed medication in a conspicuous location, and involved family members to assist with medication reminders, used split pill boxes, and recorded medication notes were higher than those in the control group. The difference was statistically significant (P<0.05) . Conclusion The rational medication management model for the elderly in the community can help strengthen the family doctor team services, enhance the patients' knowledge and belief in rational medication use, and improve the patients' adherence and standardization of medication use behavior.
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