地域在住高齢者の服薬管理の工夫と服薬アドヒアランス

Medication Self-management Strategies and Adherence in Community-dwelling Older Adults

要旨

　目的：地域在住高齢者の服薬支援の在り方を検討するために，服薬アドヒアランス良群・不良群別に対象者の属性を検討し，2群の服薬管理の工夫の特徴を示した．

　方法：地域在住高齢者55名を対象に，属性と服薬アドヒアランスに関する質問紙調査と，服薬管理の工夫に関する聞き取りおよび観察を行った．

　結果：服薬アドヒアランス良群は19名（34.5％），不良群は36名（65.5％）であり，全対象者が何らかの服薬管理の工夫を行っていた．【服薬指示理解と服薬の段取り】は〈服薬指示を記憶する〉など13の工夫，【薬の保管】は〈1週間分程の薬を手元に置く〉など10の工夫，【薬の飲み忘れ対策】は〈食事から服薬までを一連の流れで行う〉など9の工夫がされていた．

　結論：服薬管理の工夫は，個人の生活に合わせて調整されていた．したがって，看護師は対象者の生活と服薬管理の工夫を把握した上で，服薬支援を行うことが必要である．

　Objective: To consider the ideal way to support community-dwelling older adults to take medicine correctly, we compared the attributes of subjects in good and bad medication adherence groups and then analyzed the characteristics of the medication self-management strategies used by these two groups.

　Methods: We surveyed 55 community-dwelling older adults with a questionnaire to examine their background and medication adherence. Their medication self-management strategies were identified through observation and interviews.

　Results: Of the 55 subjects examined, 19 (34.5%) had good medication adherence, while the remaining 36 (65.5%) had poor adherence. All subjects were found to have devised some form of medication self-management strategies. In the medication instructions and setup, there were 13 medication self-management strategies, such as “memorizing medication instructions”; in medication storage, there were ten strategies, such as “storing medicines scheduled for the week in the place where the person spends most of his or her time”; and in the measures against forgetting timely medicine intake, there were nine strategies, such as “going from eating to taking medicine in a series of steps.”

　Conclusions: The self-management strategies were tailored to the individual's daily life. Therefore, it is important to understand one's daily life and medication self-management strategies before providing medication support.