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Journal of the Korean Geriatrics Society 1997;1(1):25-30.
Published online October 30, 1997.
Drug Compliance and Occurrence of Adverse Drug Reactions According to Activities of Daily Living(ADL) Function of Elderly Diabetic Patients
Hyung Joon Yoo, Min Sook Park, Won Seon Hong, Keun Youl Kim
1Department of Internal Medicine, Ulsan University School of Medicine, Seoul, Korea.
2Department of Internal Medicine, Dankuk University School of Medicine, Chunahn, Korea.
노인 환자의 일상생활동작(ADL) 정도에 따른 복약 상황과 부작용
Abstract
BACKGROUND
To investigate the effect of ADL on the drug compliance and the occurrence of drug side reactions in elderly diabetic out-patients, we performed a study concerning prescriptions.
METHODS
Eighty six elderly diabetic out-patients(65~92 year-old)were divided into two groups by the function of ADL(normal ADL group> or =5 score, impaired ADL group< or = 4 score). Four weeks after prescription we examined the account of remaining medicines and the occurrence of adverse drug reactions. Patient compliance with drug therapy was assessed by counting the remained drugs at 4 week according to the following criteria: 2 or 3 days of prescribed drugs, 95% compliance; 1 week, 75%; 2 weeks, 50%; and 3 weeks or more, 25%. The frequency of drug adverse reaction is expressed as the percentage of the number of patients experienced side effect(s) over the total number of patients in each group during 4-weeks.
RESULTS
Drug compliance was significantly higher in normal ADL group than in impaired Group(normal 87+/-15.6%, impaired 66+/-14.1%, p<0.01). Drug side effects were more in impaired ADL group than in normal group(impaired ADL group 26.3%, normal group 10.4%). Five normal ADL patients and 10 impaired ones had a total of 20 adverse events.
CONCLUSIONS
ADL performance influenced the drug intake compliance and the frequency of drug side effects in elderly diabetic out-patients.
Key Words: ADL, Drug intake compliance, Side effect, Elderly diabetics
초 록

배경: 노인의 기능을 총합적으로 나타내는 ADL 수행정도와 약물 복용 순응도 및 약물 부작용 발생 정도 사이의 연관성을 파악하고자 함.

방법: 외래 추구 진료를 받고 있는 86명의 경구용 약물만을 복용중인 당뇨병 환자들(65∼92세)을 ADL 수행정도에 따라 2군(정상 ADL군: ADL 5; 손상 ADL군: ADL 4)으로 나누어, 약물 처방후 4주후에 복용순응도와 부작용 발생을 판정하였다. 약물복용 순응도는 4주후 추구 진료시에 잔여 약물 수를 확인하여 각각의 약물마다 1∼2 일분이 남았으면 95% 순응도, 1주 분이 남으면 75%, 2주분 50%, 3주분 25%으로 각 약물마다 평가하여 각 약물의 순응도 %를 합산 평균하여 그 환자의 순응도로 하였다. 부작용 발현율은 각 군의 전체 환자수에 대한 부작용 발생환자 수에 대한 부작용 발생 환자 수의 백분율로 구하였다.

결과: 약물의 복용 순응도는 정상군이 87±15.6%, 제약군이 66±14.1%으로 정상 ADL군에서 손상 ADL군보다 높았다. 부작용은 정상군 48명 중 5명에서 발현하였고(부작용 발현율 10.4%), 제약군 38명 중에선 10명이 발현하여(부작용 발현율 26.3%) 정상군보다 제약군에서 더 많은 환자에서 부작용이 발생하였다.

결론: 노인 당뇨병환자에서 ADL수행정도는 약물의 복용 순응도와 약물부작용 발생에 유의한 영향을 미쳤다.

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