PRESCRIPTION DRUG MISUSE AMONG THE ELDERLY (AGING, GERONTOLOGY, SOCIOLOGY, PHARMACOLOGY, NURSING).

摘要

The purpose of this study was to determine the causes of prescription drug misuse among older people. Based on the literature, a predictive model was developed in order to test the causal relationships of drug misuse with 24 variables. Data were collected from 300 respondents to a questionnaire mailed to 600 persons aged 60 and over randomly selected from the voter registration list of a suburban county in a large southern city. The model was subjected to path analysis and was trimmed twice leaving 13 significant path relationships. Using this final model, which accounted for 23% of the variance in prescription drug misuse, the original correlations were regenerated with a fair amount of accuracy. The strongest direct predictors of misuse were the number of prescription drugs being taken, the number of physicians being seen , the lack of label information on the medication containers, the length of time taking the current prescription drugs, and a belief among respondents who valued health highly that one's health is subject to chance. The strongest indirect predictors of misuse were health status, social status, income, and two other dimensions of health locus of control--internality and belief in powerful others. These findings have implications for health care professionals, future research, and older persons themselves. Since the more physicians one sees, the more prescription drugs one takes, and the more prescription drug misuse one reports, it would seem productive to improve medical curricula and continuing education in the fields of geriatrics and geriatric pharmacology. Improved geriatric education of nursing and pharmacy students should also be beneficial. Nurses and pharmacists can help in drug education and handling of complex drug regimes. For the elderly, health education programs could be offered that are designed to foster a more internal and less chance and powerful-others locus of control since these were the directions in which these variables were associated with misuse in the final model.