地域医療と健康教育

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Current Healthcare System for Community Residents with Dementia: A Questionnaire Survey for Dispensing Pharmacies, Home Care Support Offices, and Visiting Care Support Offices

Kyoko Akanuma Hiroshi Aoki Yuko Sato Yumiko Chiba and Kenichi Meguro

Background: Since the number of dementia specialists is limited, dispensing pharmacies provide early detection of dementia patients in the community and drug management instructions, and care managers, who contribute to the collaboration between medical treatment and nursing care, play an important role. This investigation was performed with the aim of clarifying the awareness of dementia medication and actual psychosocial intervention to prepare materials for discussions on a system to provide effective care.

Methods: The subjects were 80 dispensing pharmacies, 114 home care support offices, and 117 visiting care support offices in Osaki City and Kurihara City in Miyagi Prefecture. The questionnaires were distributed on November 8, 2012, and responses were received until November 27, 2012.

Results: For antidementia drugs, the answers from the dispensing pharmacies and home care support offices were generally favorable, but many visiting care support offices answered that the drugs were for “general dementia, not for Alzheimer disease (AD). For psychosocial intervention, all of “physical activities,” “activities using reality orientation and reminiscence approach,” and “work and recreation” were performed during past 1 month, but “physical activities” were most reported as regular activity. Regarding reasons for the intervention, the most often reported response was “Reported that the activity would be good for physical and brain conditions”, followed by “users seem to be having fun.”

Conclusion: Knowledge about antidementia drugs was generally favorable, but further clarification will be required for visiting care support offices. For this, smooth communication will be necessary between physicians and care providers. Among the interventions performed in visiting care support offices, “exercise” was most common. This might be confused with the evidence of exercise intervention for mild cognitive impairment (MCI). Therefore, feedback to magazines etc. used in the visiting care support offices will be essential.