Medication adherence and beliefs about medication in elderly patients living alone with chronic diseases

Abstract

PurposeThe aim of this study was to assess medication adherence and its related factors among elderly people living alone with chronic diseases using a conceptual framework with the Belief about Medicines Questionnaire and the Adherence to Refills and Medication Scale-Korean version.Participants and methodsThis was a cross-sectional study conducted in 3,326 elderly people living alone, who were enrolled in Seongnam Center for Home Health Care in South Korea. They completed validated questionnaires assessing their adherence and beliefs about medication in general.ResultsIn attitudinal analysis using Belief about Medicines Questionnaire, 37.0% of patients were accepting of medication (high necessity with low concerns), 49.7% were ambivalent (high necessity with high concerns), 1.9% were skeptical (low necessity with high concerns), and 11.4% were indifferent (low necessity and low concerns). In multivariable analysis, we found that adherence was related to patients’ beliefs about medication; compared with patients who were accepting of medication, those in the other three attitudinal groups had significantly lower adherence (indifferent, p=0.003; skeptical, p=0.001; ambivalent, p<0.001). Also, low adherence was associated with heavy burden of drug costs (β=0.109; 95% CI 0.03, 0.19), presence of drug side effects (β=0.431; 95% CI 0.11, 0.75), dissatisfaction with medication (β=−0.626; 95% CI −0.77, −0.48), perceiving health status as poor (β=−0.151; 95% CI −0.27, −0.03), and receiving medical aid (β=0.655; 95% CI 0.42, 0.89). Gender, age group, and number of prescribed medication were not associated with medication adherence.ConclusionTo improve medication adherence of elderly living alone, it is essential to identify barriers to adherence, including their concerns and attitudes toward medications. These factors associated with adherence should be considered in further intervention studies.

<p>Self-Reported Nonadherence Associated with Pharmacy and Home Medication Management Inconvenience Factors in a US Adult Population</p>

“…Satisfaction, or rather not being satisfied with one's method of managing and organizing medications, increased the odds of nonadherence likelihood by two-fold in our study. Similar findings have linked satisfaction with nonadherence; [34][35][36][37][38] however, these other studies focused on different aspects of satisfaction like provider communication [34][35][36] and satisfaction with medications 35,37 rather than satisfaction with the medication management and organization aspects, as in our study. Recent evidence suggests that packaging can improve adherence, but the maximal impact on adherence and clinical outcomes stems from the combination of the packaging with medication therapy management services.…”

<p>Psychometric Evaluation of Chinese Version of Adherence to Refills and Medications Scale (ARMS) and Blood-Pressure Control Among Elderly with Hypertension</p>

“…[13][14][15][16] However, all studies have been conducted in hospitals, and none have been applied to the elderly in the daily practice setting, especially for the elderly who live alone with a high risk of medication nonadherence. 17 Therefore, this study aimed to validate a Chinese translation and culturally adapted version of the ARMS-10 and to evaluate its psychometric properties among elderly hypertensive Chinese patients. Secondary objectives were to identify demographic and clinical factors that affect levels of medication adherence and BP control.…”

Association between non-adherence behaviors, patients’ experience with healthcare and beliefs in medications: a survey of patients with different chronic conditions

“…patient-, disease-, condition-, social/economic-and health systemrelated 1,2 ). In chronic disease, several studies have shown a relationship between adherence and patients' beliefs in medicines [5][6][7][8][9][10][11][12] . Higher adherence rates in chronic disease have also been equated with better patient experiences with current and past care 13,14 .…”

“…Understanding the impact of patients' experiences and patients' beliefs' on nonadherence behaviors is very relevant because it can guide the implementation of specific preventative actions for patients with chronic conditions. Although studies have demonstrated a link between patients' beliefs in medicines and patients' healthcare experience with adherence [5][6][7][8][9][10] , to the best of our knowledge, no studies have been conducted that have included both experience with healthcare and beliefs in medications as covariates for their association with behaviors of medication adherence/non-adherence in patients with different chronic conditions. Moreover, it is also important that this information is self-reported by patients to avoid potential bias imposed by the intervention of the clinical team.…”

“…The professionals who care for me review with me all of the medication I take, how I take it and how it suits me. The professionals who care for me are concerned with my quality of life and I feel they are committed to my wellbeing 10…”