Consumption Behaviors Related to Drugs in Elderly Patients with Hypertension or Type 2 Diabetes Mellitus at Kho Hong City: A Mixed Methods Study
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Abstract
Objective: To determine adherence to currently used medications for hypertension, type 2 diabetes mellitus or other chronic diseases, factors related to such behavior, and problems and barriers arising from drug use among patients with hypertension, type 2 diabetes mellitus. Methods: This study was a mixed method study consisting of two phases. Phase 1 was a quantitative cross-sectional descriptive study involving 205 elderly patients at the primary care clinic in Songklanakarind Hospital. The study collected clinical information, medication adherence as measured by the Medication Adherence Scale in Thais (MAST©), and health literacy as measured by the Thai Health Literacy Assessment Using Word List with Extended Questions to Test Comprehension (THLA-W+). Phase 2 was a qualitative study involving in-depth interviews with seven informants using a semi-structured questionnaire. Results: 185 patients (90.24%) had an adequate medication adherence. Adequate control of diseases was found in 142 hypertensive patients (74.75%) and 32 patients with type 2 diabetes (39.02). Adverse drug reactions were found in 2.49% of the participants. Identified problems and barriers from drug uses included adverse drug reactions, non-concordance between daily life/meal times and drug uses, and negative attitudes towards modern medicines and treatments, contributing to inadequate medication adherence. Factors facilitating adequate medication adherence were spouses (P=0.006) who reminded patients on regular drug uses, concordance between daily life and drug uses, modification of drug use to fit with daily life and positive attitudes towards health professionals. Conclusions: Positive attitudes towards medication therapy and health professionals, concordance between drug taking and daily life, and adjustment of the patient’s behavior contribute to adequate medication adherence.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
References
National Statistical Office. Elderly at present and in the future [online]. 2019 [cited Feb 19, 2019]. Available from: www.nso.go.th/sites/2014/Pages/Acti vityNSO/2561/A12-04-61-1.aspx
Prasartkul P, editor. Situation of the Thai elderly 2016. Bangkok: Foundation of Thai Gerontology Research and Development institute; 2017. p.13.
Aekplakorn W, editor. Thai National Health Examina- tion Survey, NHES V. Bangkok: Aksorn graphic and design; 2016.
Hallas J, Gram LF, Hamlon JT. Polypharmacy in eldetly patients. Am J Geriatr Pharmacother. 2007; 5: 345–51.
Olsen CG, Tindall WN, Clasen ME. Geriatric pharma cotherapy: A guide for the helping professional. Washinton DC: American Pharmacist Association; 2007. p.35–44.
Sinnott C, Bradley CP. Multimorbidity or polyphar- macy : Two sides of same coin? J Comorb. 2015; 5: 29–31.
Shah BM, Hajjar ER. Polypharmacy, Adverse drug reactions, and geriatric syndromes. Clin Geriatr Med. 2012; 28: 173–86.
Chaichanawirote U, Vithayachockitikhun N. Medica- tion use behaviors among older Thai adults. Journal of Nursing and Health Sciences. 2015; 9: 32–46.
Vlieland ND, van den Bemt BJF, Wouters H, Egberts ACG, Bouvy M, Gardarsdottir H. Associations between personality traits and adequate home storage of drugs in older patients. Psychol Health Med. 2019; 24: 1255–66.
Sarapak A. Elder-friendly medicine and system to improve adherence. In: Health and social innovations for aging populations. Bangkok: Thai Society of Gerontology and Geriatric Medicine; 2019. p.73-86.
Yang Q, Chang A, Ritchey M, Loustalot F. Hyperten sive medication adherence and risk of cardiovas cular disease among older adult: A population-based cohort study. J Am Heart Assoc. 2017; 6: e006056. doi: 10.1161/JAHA.117.006056.
Lin LK, Sun Y, Heng BH, Chew DEK, Chong P. Medication adherence and glycemic control among newly diagnosed diabetes patients. BMJ Open Diabetes Res Care 2017; 5: e000429. doi: 10.1136/b mjdrc-2017-000429.
Kerdsri K, Lerkiatbundit S. Relationship between health literacy and self-protection ability among consumers in health products. Thai Journal of Pharmacy Practice. 2018; 10: 239–48.
Saiseng T, Jithaisong W, Suttiprapa K, Phattaraben japol S. Health literacy of patients with diabetes at a primary health care setting in Ubon Ratchathani province [online]. 2014 [cited Oct 10, 2019]. Available from: www.phar.ubu.ac.th/conference2014 /wp-content
Leetaweesuk J, Makee P, Charachan P, Yana P, Jindawattanawong P, Thiratanyaboon L, et al. Drug use behaviors of elderly patients with chronic disease in Chiang-Tong community Rahang Sub-District, Muang-Tak District, Tak Province [online]. n.d. [cited Aug 5, 2019]. Available from: www.med. nu.ac.th/qa/med_sar/ckfinder/userfiles/Hospital/21/files/5.1/พฤติกรรมการใช้ยาของผู้ป่วยสูงอายุโaeเรื้อรังในชุมชนเชียงทอง ตำบลระแหง อำเภอเมือง จังหวัดตาก.pdf
Rodgers JE, Thudium EM, Beyhaghi H, Sueta CA, Alburikan KA, Kucharska-Newton AM, et al. Predic- tors of medication adherence in the elderly: The role of mental health. Med Care Res Rev. 2018; 75: 746–61.
Welz AN, Emberger-Klein A, Menrad K. Why people use herbal medicine: insights from a focus-group study in Germany. BMC Complement Altern Med 2018; 18: 92. doi: 10.1186/s12906-018-2160-6.
Tse M, Chan KL, Wong A, Tam E, Fan E, Yip G. Health supplement consumption behavior in the older adult population: an exploratory study. Front Public Health. 2014; 2: 1–8.
Masumoto S, Sato M, Maeno T, Ichinohe Y, Maeno T. Factors associated with the use of dietary supplements and over-the-counter medications in Japanese elderly patients. BMC Fam Pract 2018; 19: 1–7.
Altizer K, Quandt SA, Grzywacz JG, Bell RA, Sanberg J, Arcuury TA. Traditional and commercial herb use in health self management among rural multiethnic older adults. J Appl Gerontol. 2013; 32: 387–407.
Kaeodumkoeng K, Thummaku D. Health literacy promoting in aging population. Journal of Health Science Research. 2015; 9: 1–8.
Choeisuwan V. Health literacy : Concept and application for nursing practice. Royal Thai Navy Medical Journal. 2017; 44: 183–97.
Aekakul T. Research methodology in behavioral sciences and social sciences. Ubon Ratchathani: Ubon Ratchathani Rajabhat University; 2000.
Kongkaew C, Methaneethorn J, Mongkhon P, Dechanont S, Taburee W. Drug-related problems identified at patients’ home: A prospective observational study in a rural area of Thailand. J Patient Saf 2021 17: 8-14. doi: 10.1097/PTS.0000 000 000000404.
Hayibueraheng H. Development of the Thai Health Literacy Assessment Using Word List with Extended Questions to Test Comprehension (THLA-W+): Testing in communities [master thesis]. Songkhla: Prince of Songkla University; 2019.
Suphachamroon A, Lerkiatbundit S, Saengcharoen W. Validity and reliability of the medication adherence scalein Thais (MAST): testing in diabetes patients. Thai Journal of Pharmacy Practice. 2018; 10: 607–19.
Sindecharak T. Statistics. Bangkok: Thammasat University; 2015.
Chirawatkul S. Qualitative study in nursing. Bang kok: Witayaphat; 2012.
Thai Hypertension Society. Guidelines in the treat ment of hypertension 2019 [online]. 2019 [cited Apr 18, 2019]. Available from: www.thaihypertension.org /files/442.HT%20guideline%202019.with%20watermark.pdf
The Royal College Physicians of Thailand. Clinical practice guideline for diabetes 2017 [online]. 2017 [cited Apr 20, 2019]. Available from: www.dmthai.org /attachments/article/443/guideline-diabetes-care-20 17.pdf
Muangpaisan W, Pisalsalakij D, Intalapaporn S, Chatthanawaree W. Medication non-adherence in elderly patients in a Thai geriatric clinic. Asian Biomedicine. 2014; 8: 541–5.
Wongwattanasathien O, Tongsodsang K, Ngamg leng C. Problems of medicine and dietary supple ment use of the elders in town municipality, Maha Sarakham Province. Rajabhat Maha Sarakham University Journal. 2015; 9: 67–74.
Wongboonnak P, Wongtrakul P, Mahamongkol H, Neimkhum W. The survey of medicine, food supplement and herbal products used problems among elderly: A case study at the community of Tumbon Srisa Chorakhe Noi, Samut Prakan Province. HCU Journal of Health Science. 2016; 20: 97–108.
Kengganpanich T, Leerapan P, Kengganpanich M, Nunthasen K, Lattanand K. Factors related to herbal consumption controlling blood sugar of patients with type 2 diabetes mellitus. Journal of Boromarajonani College of Nursing. 2015; 31: 13–25.
Barat I, Andreasen F, Damsgaard EMS. Drug therapy in the elderly: what doctors believe and patients actually do. Br J Pharmacol. 2001; 51: 615–22.
Naiyapatana W. Health problems, medicine-used problems, and medicine-used behaviors among elderly in the community of Phramongkutklao Hospital personnel’s residence. Journal of Nursing and Education. 2010; 3: 2–14.
Kwint H, Stolk G, Faber A, Gussekloo J, Bouvy M. Medication adherence and knowledge of older patients with and without multidose drug dispensing. Age Ageing. 2013; 42: 620–6.
Furmedge DS, Stevenson JM, Schiff R, Davies JG. Evidence and tips on the use of education compliance aids. BMJ. 2018; 362:k2801. doi: 10.1136/bmj.k2801.
