本研究调研分析了老年慢性病患者居家服药的依从性情况及其影响因素，在此基础上对当前老年慢性病患者居家服药的流程进行了改进设计。 用户研究阶段选取15名年龄范围64-88岁患有高血压、冠心病等慢性疾病需长期服用口服药治疗的患者进行一对一访谈，调研老年慢性病患者居家服药的大致流程以及服药过程中存在的问题，以此为基础编制服药情况调查问卷。以保护动机理论为依据自编量表，分析导致患者服药依从性差的心理因素。结合Morisky服药依从性量表，对患有终末期肾脏病需要维持性血液透析治疗的100名老年患者进行横断面调查。调查内容包括人口学资料、患病种类、服药相关情况、分药方式、服药依从性以及依从性差可能的原因或动机。 调研结果发现，该群体服药依从性差的比例为48%，主要为忘记吃药而导致的无意不依从服药。女性相比于男性可能更容易忘记吃药。相比于自己或其他亲属分药的患者，由保姆分药的患者不容易发生忘记吃药的情况。对保护动机理论的各个维度进行分析可以发现，严重性、反应效能和自我效能得分越高的患者服药依从性越高；易感性、内在奖励、外在奖励和服药代价得分越高的患者，服药依从性越低。对分药装置和提醒服药的需求进行分析，可以得出年龄越大、服药种类越多的患者对分药装置的接受程度越高，容易忘记服药的患者更加期待他人提醒自己服药。 以上结果说明对本研究所调研的被试群体而言，服药依从性差的主要类型为遗忘所导致的无意不依从服药，且患者对分药和提醒服药的需求较高。在此基础上，本研究对老年慢性病患者居家服药流程进行了一系列改进。改进后的服药流程以患者的需求为中心，设计以分药和提醒服药功能为主的智能分药机，依托互联网环境，将家庭医生、患者和家属串联起来：家庭医生根据患者病情开具口服药的处方，医院信息管理系统将处方生成二维码并打印出来；患者取药回家后用手机扫描处方二维码，处方内容联网上传至智能分药机。患者根据分药机提示将药从包装中取出放入分药机储药盒中，机器根据医嘱内容设定服药计划反馈至手机APP端；分药机定时定量将药物分出并通过手机语音提醒患者服药。分药装置记录患者服药情况并分析，必要时通知紧急联系人或家庭医生；患者服药数据上传至医院的信息管理系统，患者复诊时，医生可打开软件查看患者的服药数据作为诊断参考，并可针对性地对患者进行健康教育，减少患者对于某些药物的顾虑。 将改进后的服药流程分别以故事板和视频动画的形式呈现，选取医护人员进行NPS（净推荐值）评分并提出改进意见和建议。

This study investigated and analyzed the compliance and its influencing factors of elderly patients with chronic diseases in taking medicine at home. On this basis, the current process of elderly patients with chronic diseases taking medicine at home was improved. 15 patients aged between 64 and 88 years with chronic diseases such as hypertension and coronary heart disease who need long-term oral medication were selected for one-to-one interview during user research stage. The general process and probable problems of taking medicine at home for elderly patients with chronic diseases were investigated through interviews, based on which a questionnaire on medication was prepared. Based on the Protective Motivation Theory, a self-designed scale was developed to analyze the psychological factors leading to poor drug compliance. Combined with Morisky medication compliance scale, a cross-sectional survey was conducted on 100 elderly patients with end-stage renal disease requiring maintenance hemodialysis treatment. The survey included demographic data, types of illness, medication related conditions, drug distribution, medication compliance, and possible reasons or motivations for poor compliance. According to the survey results, the proportion of poor medication compliance of this group is 48%, which is mainly caused by the unintentional non-compliance caused by forgetting to take medicine. Women may be more likely than men to forget to take their medication. Patients whose medication were dispensed by a nanny were less likely to forget to take their medication than those whose medication were dispensed by themselves or other relatives. The analysis of each dimension of protection motivation theory shows that patients with higher scores of severity, response efficiency and self-efficacy have higher medication compliance. Patients with higher scores for susceptibility, intrinsic reward, extrinsic reward, and cost of medication had lower compliance. By analyzing the demand of drug dispensing device and drug reminding device, it can be concluded that patients who are older and take more drugs have higher acceptance of drug dispensing device, and patients who tend to forget to take drugs are more expecting others to remind them to take medicine. The above results show that the main type of poor drug compliance of the subjects investigated in this study is unintentional non-compliance caused by forgetting, and patients have a high demand for drug dispensing and reminding. On this basis, this study made a series of improvements in the home medication process for elderly patients with chronic diseases. The improved medication process centers on the needs of patients, and a drug dispensing device focusing on drug dispensing and drug reminding function is designed. Relying on the Internet environment, the family doctor, patients and their families are connected in series: The family doctor prescribed the oral medicine according to the diagnosis of the patient, and the hospital information management system generates the prescription into a QR code and prints it out. After getting the medicine, patients scan the prescription QR code with their mobile phones and upload the prescription contents to the smart dispensers through the Internet. According to the instructions of the dispenser, the patient takes the medicine out of the package and puts it into the dispenser's medicine storage box. The machine sets the medication plan according to the doctor's advice and sends it back to the mobile APP. The drug dispenser separates the drugs at fixed time and quantitatively and reminds the patient to take the medicine through the phone voice. The dispensing device records the patient's medication status and analyzes it, and notifies the emergency contact or family doctor if necessary. Patients' medication data is uploaded to the hospital's information management system. When patients return to the hospital, the doctor can open the software to view the patient's medication data as a diagnostic reference, and can conduct targeted health education for patients to reduce their concerns about certain drugs. The improved medication process was presented in the form of storyboard and video animation. Several doctors and nurses were selected to score the NPS (net recommended value) of the improved process and put forward suggestions for improvement.