Abstract
Whether elderly patients can take prescription drugs as directed by a physician is often unclear. So elderly patients could receive adequate instruction regarding their medications, we developed a regimen comprehension scale (RCS) with simple questions regarding information on dosage and administration. This information was written on the outside of the paper bags in which the medications are usually dispensed. The subjects were 21 healthy volunteers (11 men and 10 women, averaged age 38.3±11.2 years) and 17 inpatients (9 men and 8 women, averaged age 73.1±6.8 years). Five kinds of drugs, which differed with respect to dosage and administration were used. The subjects were questioned in an interview about taking the five drugs and their regimen comprehension was assessed with the RCS (maximum score: 10 points, lowest score: -10 points). Then regimen comprehension was classified into 4 grades: normal (10), caution needed (9 or 8), training needed (7 or 6), and assistance needed (5 or less). In addition, intelligence was tested with the revised version of Hasegawa's dementia scale (HDS-R). Eight of the 21 healthy volunteers (38%) and 13 of the 17 elderly patients (76%) misunderstood some aspects of the regimens written on the paper bags. The regimen comprehension was classified as “normal”, “caution needed”, and “training needed” in 13, 7, and 1 of the healthy volunteers, respectively, it was classified as “normal”, “caution needed”, “training needed”, and “assistance needed” in 4, 4, 4, and 5 elderly patients, respectively. The five elderly patients classified as “assistance needed” were suspected to have dementia because they had scores on the HDS-R of 21 or less. A significant positive correlation (r=0.797) was noted between scores on the HDS-R and on the RCS. When treating elderly patients with chronic disease (for example, hypertension) it is important to evaluate their regimen comprehension with an index such as the RCS to determine the need for medication counseling before the start of a medication regimen.
