Abstract
BackgroundVarious factors are related to self-management of medication. However, few reports comprehensively examine the factors related to patients, medication levels, and other factors related to the recuperative environment, such as family support. The aim of this study was to investigate factors affecting the continuation of medication self-management among hospitalized older adults receiving convalescent rehabilitation.MethodsWe conducted a retrospective observational study with 274 consecutive patients newly admitted to the convalescent rehabilitation wards at a single hospital in Japan between January 2017 and May 2018. Participants who were assessed for their ability to take their medication using the Japanese Regimen Adherence Capacity Tests, were deemed to be self-manageable, and were able to successfully continue to self-manage their medication from admission to discharge were categorized as the “continuation group,” and those who were not able to continue were categorized as the “non-continuation group.” We analyzed the groups’ demographic data, laboratory data, and Functional Independence Measure. The primary outcome was the continuation of medication self-management from admission to discharge.ResultsAfter enrollment, 134 patients (median age 82 years; 62.7% women) were included in the final analysis. Some 60.4% of eligible patients were able to maintain medication self-management during their hospitalization. The multiple logistic regression analysis for the continuation of medication self-management during hospitalization after adjusting for confounding factors revealed that pharmacist medication instructions were independently and positively correlated with successful continuation of medication self-management (odds ratio: 1.378; 95% confidence interval 1.085–1.831; p = 0.0076).ConclusionSuccessful continuation of medication self-management is associated with pharmacist medication instructions among hospitalized older adults undergoing rehabilitation.Trail registrationThe Ethics Committee’s registration number is “TGE01216–066”.
Highlights
Various factors are related to self-management of medication
We examined the factors affecting the continuation of medication self-management in elderly patients in the convalescent rehabilitation ward, taking into account factors related to patients and their medication levels as well as factors in the recuperative environment, such as family support
body mass index (BMI) at admission, the diagnosis of hypertension and dyslipidemia, Hasegawa dementia rating scale-revised (HDS-R), the number of medication instructions, functional independence measure (FIM)-T, functional independence measure-cognitive (FIM-C) at admission, and FIM-T, functional independence measure-motor (FIM-M), and FIM-C at discharge were significantly higher in the continuation group compared with the non-continuation group
Summary
Various factors are related to self-management of medication. few reports comprehensively examine the factors related to patients, medication levels, and other factors related to the recuperative environment, such as family support. The aim of this study was to investigate factors affecting the continuation of medication self-management among hospitalized older adults receiving convalescent rehabilitation. The primary purpose of the convalescent rehabilitation ward is to provide intensive rehabilitation for patients with stroke, femur fracture, and hospital-associated deconditioning. The convalescent rehabilitation ward is characterized by a long hospital stay and a significant number of elderly patients. The direct cause of their hospitalization, and their underlying medical condition prior to admission makes many elderly patients prone to polypharmacy due to the high number of medications they take. A previous report had shown that 33% of patients in the convalescent rehabilitation ward were found to have polypharmacy [1]. Polypharmacy is a known cause of poor medication adherence [2]. Poor medication adherence has a negative impact on the treatment and control of disease and affects the occurrence of adverse effects due to medications
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