Older patients's self-reported health and association with clinical and sociodemographic factors

Cilj ovog rada bio je utvrditi povezanost doživljaja vlastitog zdravlja u pacijenata starijih od 65 godina s brojem lijekova koje pacijent koristi, bolestima od kojih boluje, simptomima koje ima, postojanju ograničenja u kretanju te demografskim čimbenicima (spolu i dobi pacijenata). Presječno opservacijsko istraživanje bilo je provedeno tijekom srpnja i kolovoza 2019. godine u ljekarnama na području Istre. Korišten je upitnik, razvijen je za potrebe istraživanja EuroAgeism projekta FIP 7 Horizon 2020 pod nazivom „Neprikladno propisivanje lijekova i dostupnost upravljanja terapijom u starijih osoba u Europi“. Ispitanici su bili osobe starije od 65 godina koje su podizale svoju terapiju u navedenim javnim ljekarnama. U istraživanju je sudjelovalo 100 pacijenata od kojih je 66% bilo žena. Prosječna dob ispitanika bila je 74,89 ± 6,304 i oni su prosječno koristili 5,74 ± 3,215 lijekova. Najveći broj ispitanika smatrao je da je njihovo zdravlje dobro (47%) ili osrednje (33%). Pronađena je statistički značajna povezanost između doživljaja vlastitog zdravlja i spola osobe (p=0,035). Za razliku od žena, koje su u značajnoj mjeri svoje zdravlje ocijenile loše ili osrednje, muškarci su većinom svoje zdravlje ocijenili dobrim ili vrlo dobrim, dok između doživljaja vlastitog zdravlja i dobi starijih osoba ta povezanost nije bila značajna (p=0,154). U ovome istraživanju se stupanj pokretljivosti osoba starijih od 65 godina pokazao kao važan čimbenik koji utječe na doživljaj vlastitog zdravlja; lošija pokretljivost kao i svi ispitivani oblici poteškoća u pokretljivosti rezultirali su lošijim doživljajem vlastitog zdravlja. Značajna povezanost s doživljajem vlastitog zdravlja utvrđena je kod oboljelih od osteoporoze (p=0,001) gdje su osobe s osteoporozom ocijenile njihovo zdravlje lošije u odnosu na one koji nemaju tu dijagnozu. Druga istraživana stanja i bolesti nisu bila povezana s doživljajem zdravlja. Također, pokazalo se da su svoje zdravlje lošijim smatrale osobe koje su imale pet ili više lijekova u terapiji (p=0,030). Značajna povezanost pronađena je između doživljaja vlastitog zdravlja i pojedinih kliničkih i sociodemografskih čimbenika: osobe koje u anamnezi imaju osteoporozu, koje u terapiji imaju veći broj lijekova, slabije su pokretljive te osobe ženskog spola češće su svoje zdravlje smatrali lošijim. Rezultati ovog istraživanja potvrđuju da je subjektivna samoprocjena zdravlja kompleksna i uključuje njezino biološko, fiziološko i socijalno stanje. Postoji značajan broj čimbenika koji utječu na pacijentov doživljaj zdravlja, posebice u osoba starije životne dobi.The aim of this study was to determine the association between self-reported health in patients older than 65 years and the number of medication that they use, their comorbidities and symptoms, and their mobility restrictions, as well as demographic factors (gender and age of patients). A cross-sectional observational study was conducted during July and August 2019 in pharmacies in Istria. The questionnaire used was developed for the research of the EuroAgeism project FIP 7 Horizon 2020, entitled, "Inappropriate drug prescribing and the availability of therapy management in the elderly in Europe." Respondents were persons over 65 years of age who came into the community pharmacy to refill the prescription. The study involved 100 patients, 66% of whom were women. The average participants’ age was 74.89 ± 6.304, and they used an average of 5.74 ± 3,215 drugs. The largest number of respondents thought that their health was good (47%) or mediocre (33%). A statistically significant association was found between the self-reported health and the gender of the patients (p = 0.035). Unlike women, who rated their health as poor or mediocre, men rated their health as good or very good. The association between self-reported health and patients’ age was not significant (p = 0.154). In this study, the mobility of participants over the age of 65 was found as an important factor influencing their own health experience; poorer mobility, as well as all examined forms of mobility difficulties, resulted in poorer self-reported health. A significant association with health status was found in patients with osteoporosis (p = 0.001) where people with osteoporosis perceived their health worse than those without a diagnosis of osteoporosis. Other conditions and symptoms studied were not associated with the self-reported health status. It was also shown that participants who had five or more drugs in therapy considered their health worse (p = 0.030). A significant association was found between self-reported health and certain clinical and sociodemographic factors: participants with a history of osteoporosis, those with a higher number of drugs in therapy, less mobile people, and females were more likely to feel worse about their health. The results of this research confirm that subjective self-assessment of health is complex and includes biological, physiological and social factors. There are a significant number of factors that affect a patient’s experience of health, especially in the elderly