Medication Adherence in Elderly with Polypharmacy Living at Home: a Systematic Review of Existing Studies

Zelko, Erika; Klemenc–Ketiš, Zalika; Tušek-Bunc, Ksenija

doi:10.5455/msm.2016.28.129-132

Cited by 89 publications

(88 citation statements)

References 15 publications

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“…Although there are some published studies that suggest polypharmacy may be associated with poor medication adherence, these studies are limited by heterogeneity in the definition of adherence, by study design, small sample size, and neglect of confounding factors (Marcum & Gellad, ; Zelko, Klemenc‐Ketis, & Tusek‐Bunc, ).…”

Section: Introductionmentioning

confidence: 99%

The necessity‐concern framework in the assessment of treatment adherence of psychiatric patients and the role of polypharmacy in a Spanish sample

Cuevas

Montesinos

León

2020

Human Psychopharmacology

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Objective: This study compares three measures (necessity and concern scores, the necessity-concern differential, and a skeptical attitude vs. three other attitudes) for studying the relationship between the necessity-concern framework and treatment adherence after considering the number of prescribed drugs. Methods:The sample included 588 consecutive adult psychiatric outpatients in the Canary Islands, Spain. The necessity-concern framework was assessed using a specific subscale of the Beliefs about Medicines Questionnaire. Adherence (yes/no) to 1,101 prescribed psychiatric drugs was assessed using the Sidorkiewicz adherence tool.Results: In the three logistic regression models including 1,101 drugs, with adherence as the dependent variable, the highly significant odds ratios (ORs) and their 95% confidence intervals (CIs) were (a) OR = 1.57 (CI = 1.37-1.79) for necessity and OR = 0.747 (CI = 0.660-0.847) for concern; (b) OR = 1.44 (CI = 1.32-1.58) for the necessity-concern differential; and (c) OR = 0.452 (CI = 0.343-0.597) for a skeptical attitude (yes/no), defined as low necessity and high concern. In patients taking five or six drugs, adherence was associated with extremely high/low ORs for necessity, concern, and the differential.Conclusion: If replicated, our results suggest clinicians need to pay careful attention to each drug in each patient taking five or six drugs, emphasize necessity, and listen carefully to patient concerns.attitude to health, health behavior, medication adherence, patient acceptance of health care/ drug effects, polypharmacy, psychopharmacology, treatment adherence and compliance

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Section: Introductionmentioning

confidence: 99%

The necessity‐concern framework in the assessment of treatment adherence of psychiatric patients and the role of polypharmacy in a Spanish sample

Cuevas

Montesinos

León

2020

Human Psychopharmacology

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“…10 Patients who are taking multiple medications are at a higher risk of falling victim to medication non-adherence. 11 There are various strategies that can help improve medication nonadherence, including but not limited to, telephone refill reminders, pill boxes, alarms, education programs, and mobile application aids. 12,13 While each of these methods can help improve medication-taking behavior and medication adherence, they are often either inaccessible to patients or are seldom brought to the patient's attention.…”

Section: Introductionmentioning

confidence: 99%

Study to Measure the impact of Pharmacists and Pharmacy Services (STOMPP) on Medication Non-Adherence: Medication Adherence and Clinical Outcomes

et al. 2018

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“…Polypharmacy (having more than four drugs prescribed) was found to be highly predictive of non‐adherence ( P = .007). A review analysis by Zelko et al 33 found that for polypharmacy patients, non‐adherence rates ranged from 6% to 55%. Valladolid et al have found negative associations of medication adherence with more drugs being taken, a large cost burden 34 .…”

Section: Discussionmentioning

confidence: 99%

Necessity and concerns about lipid‐lowering medical treatments and risk factors for non‐adherence: A cross‐sectional study in Palestine

et al. 2020

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Aims Strong evidence indicates that drugs reduce blood lipids and improve cardiovascular end‐points, leading to their wide usage. However, the success of these drugs can be affected by poor patient's adherence to prescribed medication. This study aimed to evaluate medication adherence in patients with dyslipidaemia in association with patient beliefs about medicines. Methods The study was conducted from January 2019 to July 2019 at the middle governmental primary healthcare clinics in Ramallah and Bethlehem cities, and used a cross‐sectional design. Adherence was determined using the 4‐item Morisky medication adherence scale, while beliefs were determined using the Beliefs about Medicines Questionnaire. Results Of 220 patients, 185 agreed to participate in the study, resulting in a response rate of 84.1%. Of the participants, 106 (57.3%) were men, and almost half (88, 46.5%) were ≥56 years. Medication non‐adherence was high (47.6%), but a majority (65.5%) reported believing their treatment to be necessary for their continued good health. Accordingly, the mean necessity score (17.3, SD 3.7) significantly outweighed (P < .001) the mean concerns score (14.0, SD 3.5). Multivariate regression demonstrated four variables to be significantly correlated with non‐adherence: illiterate (OR = 2.52; CI: 0.9‐4.3; P = .03), polypharmacy (OR = 3.18; CI: 1.9‐5.7; P = .007), having comorbidity (OR = 3.10; CI: 2.2‐4.6; P = .005) and having concerns about side effects (OR = 2.89; CI: 1.1‐4.6, P = .04). Conclusion Non‐adherence among patients taking lipid‐lowering agents was high despite most holding positive beliefs regarding medication necessity. This may be due to concern also being high. Physicians should identify and target high‐risk patients and individualise their treatment plans in order to achieve adequate control of dyslipidaemia.

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Medication Adherence in Elderly with Polypharmacy Living at Home: a Systematic Review of Existing Studies

Cited by 89 publications

References 15 publications

The necessity‐concern framework in the assessment of treatment adherence of psychiatric patients and the role of polypharmacy in a Spanish sample

The necessity‐concern framework in the assessment of treatment adherence of psychiatric patients and the role of polypharmacy in a Spanish sample

Study to Measure the impact of Pharmacists and Pharmacy Services (STOMPP) on Medication Non-Adherence: Medication Adherence and Clinical Outcomes

Necessity and concerns about lipid‐lowering medical treatments and risk factors for non‐adherence: A cross‐sectional study in Palestine

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