Prevalence and Related Factors of Ineffective Self-Health Management in Polymedicated Patients Over the Age of 65 Years

Abstract

PURPOSE

To determine the prevalence of Ineffective Self-Health Management (ISHM) (00078) and its related factors in polymedicated patients over the age of 65 years.

METHODS

A cross-sectional, descriptive design was used. A home interview was conducted with each participant (N = 375) for data collection.

FINDINGS

The prevalence of ISHM was 37.3%. The risk factors associated were social risk, depression, noncompliance, medication errors, and confusion with medications.

CONCLUSIONS

Among polymedicated elderly patients, the prevalence of ISHM is high. The diagnosis is closely connected to the compliance and complexity of the treatment regimen, in addition to those relating strictly to social and emotional factors.

IMPLICATIONS

Nursing methodology encompasses instruments that allow nurses in clinical practice to evaluate the issue of compliance.

Keywords

Aged patient Ineffective Self-Health Management medication therapy management nursing polypharmacy

Get full access to this article

View all access options for this article.

References

Abellán-García

Pujol-Rodríguez

(2013). A profile of the elderly in Spain, 2013. Basic statistical indicators. Reports Aging Network no. 1. Madrid. Available at: http://envejecimiento.csic.es/documentos/documentos/enred-indicadoresbasicos13.pdf

Asche

LaFleur

Conner

(2011). A review of diabetes treatment adherence and the association with clinical and economic outcomes. Clinical Therapeutics, 33, 74–109.

Bandura

(1997). Self-efficacy: The exercise of control. New York: W.H. Freeman.

Bosch-Capblanch

Abba

Prictor

Garner

(2007). Contracts between patients and healthcare practitioners for improving patients' adherence to treatment, prevention and health promotion activities [Review]. Cochrane Database Systematic Review, (2):CD004808.

Boyde

Song

Peters

Turner

Thompson

D. R.

Stewart

(2013). Pilot testing of a self-care education intervention for patients with heart failure. European Journal of Cardiovascular Nursing, 12, 39–46.

Chew

B. H.

(2015). Medication adherence on quality of life among adults with type 2 diabetes mellitus: An exploratory analysis on the EDDMQoL study. Quality of Life Research, 24(11), 2723–2731. doi:10.1007/s11136-015-1006-7.

Consejo Superior de Investigaciones Científicas . (2010). Report on aging. Madrid. Available at: http://www.fgcsic.es/envejecimiento/upload/recursos_documentos.11. ccq.Descarga.Informesobreenvejecimiento.pdf

Crespillo-García

Rivas-Ruiz

Contreras-Fernández

Castellano-Muñoz

Suárez-Alemán

Pérez-Trueba

(2013). Knowledge, perceptions and attitudes involved in adherence to treatment elderly patients polymedicated from qualitative perspective. Revista de Calidad Asistencial, 28, 56–62.

Davies

N. J.

(2010). Improving self-management for patients with long-term conditions. Nursing Standard, 24(25), 49–56.

10.

deSouza, Carneiro

Dias de Oliveira

A. P.

deLima, Lopes

Bachion

M. M.

Herdman

T. H.

Moorhead

S. A.

Bottura, Leite de Barros

A. L.

(2015). Outpatient clinic for health education: Contribution to self-management and self-care for people with heart failure. International Journal of Nursing Knowledge, 22, 1–7.

11.

Dios-Guerra

Pérula de Torres

L. A.

(2012). Factors related to Ineffective Handle of Therapeutic Regimen (IHTR) in chronic patients of nursing consultation. Index de Enfermería, 21, 14–17.

12.

Donaldson

(2003). Expert patients usher in a new era of opportunity for the NHS. British Medical Journal, 326(7402), 1279–1280.

13.

Yuan

(2010). Evaluation of patient self-management outcomes in health care: A systematic review. International Nursing Review, 57, 159–167.

14.

Escamilla-Fresnadillo

J. A.

Castañer-Niño

Benito-López

Ruiz-Gil

Burrull-Gimeno

Sáenz-Moya

(2008). Reasons for therapy noncompliance in older patients taking multiple medication. Atención Primaria, 40, 81–85.

15.

Fernández-Lisón

L. C.

Barón-Franco

Vázquez-Domínguez

Martínez-García

Prendes-Haro

J. J.

Pujol de la Llave

(2006). Medication errors and non-compliance in polymedicated elderly patients. Farmacia Hospitalaria, 30(5), 280–283.

16.

Haynes

R. B.

Ackloo

Sahota

McDonald

H. P.

Yao

(2009). Interventions for enhancing medication adherence [Review]. Cochrane Database of Systematic Reviews, (2), CD000011. doi:10.1002/14651858 CD000011.pub3

17.

Henriques

M. A.

Costa

M. A.

Cabrita

(2012). Adherence and medication management by the elderly. Journal of Clinical Nursing, 21, 3096–3105.

18.

Herdman

T. H.

(Ed.) (2012). NANDA International nursing diagnoses: Definitions and classification, 2012–2014., Oxford: Wiley-Blackwell.

19.

Holt

E. W.

Muntner

Joyce

C. J.

Webber

Krousel-Wood

M. A.

, (2010). Health-related quality of life and antihypertensive medication adherence among older adults. Age and Ageing, 39(4), 481–487.

20.

Keenan

Stocker

Barkauskas

Johnson

Maas

Moorhead

Reed

(2003). Assessing the reliability, validity, and sensitivity of nursing outcomes classification in home care settings. Journal of Nursing Measurement, 11, 135–155.

21.

Köberich

Lohrmann

Mittag

Dassen

(2015). Effects of a hospital-based education programme on self-care behaviour, care dependency and quality of life in patients with heart failure—A randomised controlled trial. Journal of Clinical Nursing, 24, 1643–1655.

22.

Martínez-Riera

J. R.

(2012). Crisis and nurses. Revista Rol de Enfermería, 35(2), 108–119.

23.

McCann

T. V.

Clark

(2008). The self-efficacy model of medication adherence in chronic mental illness. Journal of Clinical Nursing, 17, 329–340.

24.

Mira

J. J.

Lorenzo

Guilabert

Navarro

Pérez-Jove

R. V.

(2015). A systematic review of patient medication error on self-administering medication at home. Expert Opinion on Drug Safety, 14(6), 815–838. doi:10.1517/14740338.2015.1026326

25.

Molina-López

Dominguez-Camacho

J. C.

Palma-Morgado

Caraballo-Camacho

M. O.

Morales-Serna

J. C.

López-Rubio

(2012). A review of the medication in polymedicated elderly with vascular risk: A randomized controlled trial. Atención Primaria, 44, 453–462.

26.

Moorhead

Johnson

Maas

Swanson

(Eds.). (2009). Nursing Outcomes Classification (NOC) (4th ed.). St. Louis, MO: Mosby Elsevier.

27.

Morilla-Herrera

J. C.

Morales-Asencio

J. M.

Fernández-Gallego

M. C.

Berrobianco-Cobos

Delgado-Romero

, (2011). Utility and validity of indicators from the Nursing Outcomes Classification as a support tool for diagnosing Ineffective Self Health Management in patients with chronic conditions in Primary Health Care. Anales del Sistema Sanitario de Navarra, 34 (1), 51–61.

28.

Mukhtar

Weinman

Jackson

S. H.

(2014). Intentional non-adherence to medications by older adults. Drugs Aging, 31(3), 149–157.

29.

Orem

(2003). Orem model. Nursing concepts in practice. Barcelona: Masson.

30.

Padilla-Zárate

M. P.

Padilla-Aguirre

A. M.

(2009). Factors related to the ineffective management of therapeutic regimen in people with type 2 diabetes. Desarrollo Científico de Enfermería, 17(9), 380–385.

31.

Pérez-Rivas

F. J.

Martín-Iglesias

Pacheco Del Cerro

J. L.

Minguet-Arenas

García-López

Beamud-Lagos

(2015). Effectiveness of nursing process use in primary care. International Journal of Nursing Knowledge, 27, 43–48. doi:10.1111/2047-3095.12073

32.

Piñeiro

Gil

Donis

Orozco

Torres

M. T.

Merino

(1997). The validity of 6 indirect methods for assessing drug treatment compliance in arterial hypertension. Atención Primaria, 19, 372–375.

33.

Rojas-Sánchez

O. A.

Rueda-Diaz

L. J.

Vesga-Gualdrón

L. M.

Orozco-Vargas

L. C.

Forero-Bulla

C. M.

Camargo-Figuero

F. A.

(2009). Effectiveness of the nursing interventions for the diagnosis ‘‘Ineffective Management of Therapeutic Regimen.’’ Enfermería Clínica, 19(6), 299–305.

34.

Saleh

Mumu

S. J.

Ara

Hafez

M. A.

Ali

(2014). Non-adherence to self-care practices & medication and health related quality of life among patients with type 2 diabetes: A cross-sectional study. BMC Public Health, 14, 431. doi:10.1186/1471-2458-14-431

35.

Sánchez-Gavira

Copé-Luengo

Gómez-Rodrígue

dela Rubia-Montero

Cabello-Domínguez

Fernández-González

(2007). Validation NOC criteria: Knowledge of the therapeutic regimen, for identifying patients with chronic problems adjustment their treatment programs. Enfermería Docente, 87, 10–12.

36.

Summer-Meranius

Engstrom

(2015). Experience of self-management of medications among older people with multimorbidity. Journal of Clinical Nursing, 24, 2757–2764. doi:10.1111/jocn.12868

37.

Torres-Pérez

L. F.

Morales-Asencio

J. M.

Jiménez-Garrido

Copé-Luengo

Sánchez-Gavira

Gómez-Rodríguez

J. M.

(2013). Impact of self-management of therapy on use of emergency health care services by patients with chronic diseases: A cohort study. Emergencias, 25, 353–360.

38.

Tuesca-Molina

Guallar-Castillón

Banegas-Banegas

J. R.

Graciani-Pérez-Regadera

(2006). Determinants of the adherence to therapeutic plan in elderly Spaniards, over 60 years of age. Gaceta Sanitaria, 20, 220–227.

39.

United Nations . (2009). World population ageing 2009. New York. Available at: http://www.un.org/esa/population/publications/WPA2009/ WPA2009_WorkingPaper. pdf

40.

VanCamp

Y. P.

VanRompaey

Elseviers

M. M.

, (2013). Nurse-led interventions to enhance adherence to chronic medication: Systematic review and meta-analysis of randomised controlled trials. European Journal of Clinical Pharmacology, 69(4), 761–770.

41.

Vedel

Ghadi

DeStampa

Routelous

Bergman

Ankri

Lapointe

(2013). Diffusion of a collaborative care model in primary care: A longitudinal qualitative study. BMC Family Practice, 4, 14–23.

42.

Viswanathan

Golin

C. E.

Jones

C. D.

Ashok

Blalock

S. J.

Wines

R. C.

, & … Lohr

K. N.

(2012). Interventions to improve adherence to self-administered medications for chronic diseases in the United States: A systematic review. Annals of Internal Medicine, 157(11), 785–795.

43.

World Health Organization . (2003). Adherence to long-term therapies: Evidence for action. Geneva: Author.