Medication adherence among the older adults: challenges and recommendations

Huang, Junjie; Wang, Haoxiang; Zheng, Zhi‐Jie; Wong, Martin Cs

doi:10.12809/hkmj205108

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…Second, although using register information is a strength, we still do not know whether the patients adhere to the prescriptions and actually take the prescribed medications. Although adherence to medications is challenging for older adults [60,61], some studies have shown high levels of adherence among older adults who had PIMs [62,63]. This may aggravate the PIM problem and increase the adverse health consequences in this vulnerable population.…”

Section: Discussionmentioning

confidence: 99%

Potentially Inappropriate Medications in Older Adults—Prevalence, Trends and Associated Factors: A Cross-Sectional Study in Saudi Arabia

et al. 2023

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(1) Background: Potentially inappropriate medications (PIMs) in older adults are associated with drug-related problems, adverse health consequences, repeated hospital admissions and a higher risk of mortality. In Saudi Arabia and some Arab countries, studies of PIMs among large cohorts of older adults are limited. This study aimed to determine the prevalence of PIMs, trends and associated factors among outpatient older adults in Saudi Arabia. (2) Methods: A cross-sectional study was carried out. Over three years (2017–2019), data on 23,417 people (≥65 years) were retrieved from outpatient clinics in a tertiary hospital in Riyadh, Saudi Arabia. PIMs were assessed using the 2019 Beers Criteria. Covariates included sex, age, nationality, number of dispensed medications, and number of diagnoses. A generalized estimating equation model was used to assess trends and factors associated with PIMs. (3) Results: The prevalence of PIMs was high and varied between 57.2% and 63.6% over the study years. Compared with 2017, the prevalence of PIMs increased significantly, with adjusted odds ratios (OR) (95% confidence interval (95% CI)) of 1.23 (1.18–1.29) and 1.15 (1.10–1.21) for 2018 and 2019, respectively. Factors associated with being prescribed PIMs included ≥5 dispensed medications (OR_adjusted = 23.91, 95% CI = 21.47–26.64) and ≥5 diagnoses (OR_adjusted = 3.20, 95% CI = 2.88–3.56). Compared with females, males had a lower risk of being prescribed PIMs (OR_adjusted = 0.90, 95% CI = 0.85–0.94); (4) Conclusions: PIMs were common with an increasing trend among older adults in Saudi Arabia. A higher number of dispensed medications, increased number of diagnoses and female sex were associated with being prescribed PIMs. Recommendations on how to optimize prescriptions and implement de-prescribing strategies are urgently needed.

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Section: Discussionmentioning

confidence: 99%

Potentially Inappropriate Medications in Older Adults—Prevalence, Trends and Associated Factors: A Cross-Sectional Study in Saudi Arabia

et al. 2023

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“…They assessed four distinct dimensions of health literacy; "access, understanding, appraisal, and application of health information in 3 areas: health promotion, disease prevention, and healthcare" scored using a four-point Likert-scale ranging from score 1 (very easy) to score 4 (very difficult) without repeating any items [36]. All scores were cumulated to a minimum of 0 and maximum of 50, which was then stratified into 4 levels of health literacy: limited health literacy level (score 0-24), problematic (score [25][26][27][28][29][30][31][32][33], sufficient health literacy level (score [34][35][36][37][38][39][40][41][42], and excellent health literacy level (score [43][44][45][46][47][48][49][50] in this present study.…”

Section: Health Literacy Instrumentmentioning

confidence: 99%

“…The complexity of their treatment regime further potentiates non-adherence to treatment plans and medication in the elderly population. Non-adherence to medication is associated with worse health outcomes, disease progression, increased hospitalization, treatment failure, and increased expenditure on healthcare [ 28 ]. Barriers to medication non-adherence among the elderly include treatment burden, inadequate health literacy, multiple comorbidities, multiple care providers, communication barriers, and complex drug regimens [ 11 , 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

Relationship between Treatment Burden, Health Literacy, and Medication Adherence in Older Adults Coping with Multiple Chronic Conditions

Selvakumar,

Sivanandy,

Ingle

et al. 2023

Medicina

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A prospective study was conducted to investigate the impact of treatment burden and health literacy on medication adherence among older adults with multiple chronic conditions (MCC) and to explore the potential moderating effects of demographic and clinical factors. Face-to-face structured interviews were conducted among older adults aged 60 and above using the Burden of Treatment Questionnaire (TBQ-15), Short Form Health Literacy Questionnaire (HLS-SF12), and Malaysia Medication Adherence Assessment Tool (MyMAAT). This study included 346 older adults aged 60 years and above with two or more chronic conditions (n = 346). Hypertension (30.2%), hyperlipidemia (24.0%), and diabetes (18.0%) were the most reported chronic conditions among participants. The mean score of treatment burden was 53.4 (SD = 28.2), indicating an acceptable burden of treatment. The mean score of health literacy was 16.4 (SD = 12.6), indicating a limited health literacy level among participants; meanwhile, the mean score of medication adherence was 32.6 (SD = 12.3), indicating medication non-adherence among participants. Medication adherence was significantly correlated with treatment burden (r = −0.22, p < 0.0001), health literacy (r = 0.36, p < 0.0001), number of chronic conditions (r = −0.23, p < 0.0001), and age (r = −0.11, p < 0.05). The study findings emphasize that multimorbid older adults with high treatment burdens and low health literacy are more likely to have poor medication adherence. This underscores the importance for clinicians to address these factors in order to improve medication adherence among older adults with multiple chronic conditions (MCC).

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Determinants of Medication Non-Adherence Among the Elderly with Co-Existing Hypertension and Type 2 Diabetes Mellitus in Rural Areas of Udupi District in Karnataka, India

Jeyalakshmi¹,

Rao²,

YN³

et al. 2023

PPA

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Purpose Medication adherence is a crucial component in the management of elderly with co-morbid chronic conditions. Hence, this study aimed to investigate the determinants of medication non-adherence among rural elderly with co-morbid chronic conditions of hypertension (HTN) and type 2 diabetes mellitus (T2DM) in India. Patients and Methods This cross-sectional study adopted the probability proportional to size (PPS) sampling technique to find the determinants of medication non-adherence among elderly residing in rural coverage areas of five randomly selected primary health centres (PHC) in Udupi district, Karnataka, India. A total of 360 elderly (72 samples from each cluster) who met the inclusion criteria and consented were interviewed using predesigned prevalidated and standardized or reliable tools. The data were coded and entered in SPSS version 16.0 and analyzed using both descriptive and inferential statistics. Results The study found that 55.6% (n=200) of rural elderly with co-morbid conditions HTN and T2DM were non-adherent to their medications and established Spearman correlation coefficient rank ( r ) value between undesirable person-related factors ( r =−0.444); good family support (including financial support) ( r =0.185); poor accessibility to healthcare facility ( r =−0.209); detrimental medication-related factors including high cost of medication ( r =−0.237) were found to be significant at 0.05 level of confidence (p < 0.05). Further, the study depicted that the chi-square test ( χ 2 ) was identified to be significantly associated (p<0.05) with a variable such as education, knowledge, number of illnesses and impairments, vision, memory, and physical impairments. Conclusion Medication adherence could be improved among rural elderly with co-morbid conditions by identifying and addressing the determinants at the earliest. Further, it is vital to identify the suitable intervention program to address these avoidable problems.

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Medication adherence among the older adults: challenges and recommendations

Cited by 3 publications

References 17 publications

Potentially Inappropriate Medications in Older Adults—Prevalence, Trends and Associated Factors: A Cross-Sectional Study in Saudi Arabia

Potentially Inappropriate Medications in Older Adults—Prevalence, Trends and Associated Factors: A Cross-Sectional Study in Saudi Arabia

Relationship between Treatment Burden, Health Literacy, and Medication Adherence in Older Adults Coping with Multiple Chronic Conditions

Determinants of Medication Non-Adherence Among the Elderly with Co-Existing Hypertension and Type 2 Diabetes Mellitus in Rural Areas of Udupi District in Karnataka, India

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