Medication adherence in the elderly

Yap, Angela Frances; Thirumoorthy, T; Kwan, Yu Heng

doi:10.1016/j.jcgg.2015.05.001

Cited by 145 publications

(137 citation statements)

References 43 publications

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“…Patients with dementia or mild cognitive impairment may have medications administered by a caregiver and thus less likely to self-discontinue. 31 In addition, patients with dementia or mild cognitive impairment may also be less likely to discontinue therapy if they are taking an acetylcholinesterase inhibitor, which may cause worsening urinary symptoms. 32 We also found that paralysis was associated with decreased risk of discontinuation.…”

Section: Discussionmentioning

confidence: 99%

Antimuscarinic use and discontinuation in an older adult population

Vouri

Schootman

Strope³

et al. 2019

Archives of Gerontology and Geriatrics

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Introduction: Although antimuscarinics are typically the first-line pharmacological treatment option for overactive bladder, patients often discontinue therapy. The aim of this research project is to identify the rate of antimuscarinic discontinuation, switching, and continuation and differences in discontinuation among different antimuscarinics. Methods: Using the 5% random sample of Medicare Claims Data, we identified a cohort of patients aged ≥ 66 years old who newly initiated antimuscarinics between January 1, 2007 and December 31, 2012. Treatment discontinuation was defined as no subsequent fills of the initial antimuscarinic in the days’ supply plus a 30 day grace period. We ascertained percentages of patients who discontinued antimuscarinics, switched antimuscarinics, or died within 12 months of antimuscarinic initiation. Cox proportional hazards models were used to determine time to discontinuation of individual antimuscarinics relative to oxybutynin immediate-release (IR). Results: Among the 42,886 new-users of antimuscarinics, 71.8% discontinued, 10.8% switched, and 3.2% died prior to antimuscarinic discontinuation or switching while only 14.2% continually filled an antimuscarinic for one year. In the multivariable analysis, patients who were initiated on oxybutynin extended-released (ER), tolterodine, trospium, darifenacin, solifenacin, and fesoterodine were significantly less likely to be discontinued therapy compared to oxybutynin IR (p<0.001). Conclusion: After one year of antimuscarinic initiation, only 14% of older adult patients continuously utilized their initial antimuscarinic therapy suggesting a need for clinical interventions to improve continual use of antimuscarinics.

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Section: Discussionmentioning

confidence: 99%

Antimuscarinic use and discontinuation in an older adult population

Vouri

Schootman

Strope³

et al. 2019

Archives of Gerontology and Geriatrics

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“…In geriatric training, comprehensive geriatric assessment is taught, and these holistic assessments take into account medications and their uses. Understanding the use of these tools will allow medical professionals to be more proficient, and be able to carry out assessment of medication adherence as part of their daily routine …”

Section: Introductionmentioning

confidence: 99%

“…Understanding the use of these tools will allow medical professionals to be more proficient, and be able to carry out assessment of medication adherence as part of their daily routine. 10,11 Our search of the literature showed that for the past 6 years, there have been no studies that provide a complete review of the literature in this area. 7 Hence, the aim of the present article was to provide a systematic review of the current literature on the factors affecting medication adherence in the geriatric population.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of the barriers affecting medication adherence in older adults

Yap

Thirumoorthy

Kwan

2015

Geriatrics Gerontology Int

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Medication adherence is a crucial part in the management of chronic diseases. As older adults form a greater proportion of the population with chronic diseases and multiple morbidities, understanding medication adherence in older adults becomes important. In the present article, we aimed to systematically review the literature for the factors associated with medication adherence in the geriatric population. We carried out a literature search using electronic databases and related keywords. 17 391 articles were reviewed in total. 65 articles were found to be relevant to our objective. A total of 80 factors of five different categories were found to be associated with medication adherence in older adults. The factors, the types of studies and the number of studies that agreed or disagreed were presented. A flower model for medication adherence was also presented to allow clinicians to better understand the complex nature of medication adherence in this population. The 80 factors reviewed were categorized into five main categories; namely, patient factors, medication factors, physician factors, system-based factors and other factors as factors affecting poor medication adherence in older adults. Clinicians need to be mindful of the complex nature of factors affecting medication adherence in this population to optimize therapeutic outcomes. Clinicians have to be more skillful to discover and to optimize the medication adherence factors in geriatric patients. The flower model is presented as a framework for clinicians to better understand the various factors affecting medication adherence in older adults. Geriatr Gerontol Int 2016; 16: 1093-1101.

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“…This is not surprising as older patients are prone to multiple comorbidities, and thus more likely to take multiple medications, and therefore may have a higher risk of nonadherence compared to younger patients [11]. We also found the average interval on weekends has more variation than weekdays.…”

Section: Data Analysis and Resultsmentioning

confidence: 53%

A social cognitive theory-based framework for monitoring medication adherence applied to endocrine therapy in breast cancer survivors

Boukhechba

Baee

Nobles

et al. 2018

2018 IEEE EMBS International Conference on Biomedical &Amp; Health Informatics (BHI)

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Poor adherence to long-term therapies for chronic diseases, such as cancer, compromises effectiveness of treatment and increases the likelihood of disease progression, making medication adherence a critical issue in population health. While the field has documented many eers to adherence to medication, it has also come up with few efficacious solutions to medication adherence, indicating that new and innovative approaches are needed. In this paper, we evaluate medication-taking behaviors based on social cognitive theory (SCT), presenting patterns of adherence stratified across SCT constructs in 33 breast cancer survivors over an 8-month period. Findings indicate that medication adherence is a very personal experience influenced by many simultaneously interacting factors, and a deeper contextual understanding is needed to understand and develop interventions targeting non-adherence.

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Medication adherence in the elderly

Cited by 145 publications

References 43 publications

Antimuscarinic use and discontinuation in an older adult population

Antimuscarinic use and discontinuation in an older adult population

Systematic review of the barriers affecting medication adherence in older adults

A social cognitive theory-based framework for monitoring medication adherence applied to endocrine therapy in breast cancer survivors

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