Multiple drug regimens: Medication compliance among veterans 65 years and older

Abstract

In this study we attempted to develop a profile that could be used prospectively to identify veterans over 64 years of age who might be at risk for medication noncompliance. Male veterans (N = 249) having from one to seven oral daily prescribed medications were studied. Instruments administered to determine their relationship to compliance were the Paired-Associate Test, the Mini Mental State, the Multidimensional Health Locus of Control, and the Standard Depression Scale. Compliance was determined by a pill count made at two home visits. Seventy-three percent of the subjects were noncompliant. Variables significantly related to noncompliance by bi-variate analysis were included in the stepwise logistic regression to develop a predictive model of noncompliance. Ethnicity and number of daily prescribed pills were the only significant variables in the final model. The model correctly classified the subjects as compliant/noncompliant in 77% of the cases. Discussions during home interviews revealed a number of common problems.

Can elderly people take their medicine?

“…Several studies have examined the correlation between compliance and cognition. The results vary [15,[22][23][24], probably due to the use of different measures of cognition.…”

Is cognitive impairment a risk factor for poor compliance among Japanese elderly in the community?

“…We found that cognitive impairment was one of the predictors for poor compliance. Some other studies failed to ®nd an association between cognitive impairment and noncompliance [9,28]. Elderly persons with cognitive impairment are conveniently excluded from most medication compliance research, perhaps because researchers are afraid that these subjects cannot give accurate information for research purposes.…”

“…However, multiple medication use was reported to increase the risk of adverse drug events and noncompliance [6,7]. Some studies have shown that the rate of medication compliance with long-term therapy was only 40±60% in elderly people [4,8,9]. Medication noncompliance among elderly persons may result in declining health, increased costs for health care, and increased preventable hospital admission [10] or emergency department visits [11,12].…”

Predictors of Medication Adherence Using a Multidimensional Adherence Model in Patients With Heart Failure

“…There is, however, considerable inconsistency in findings and a number of other investigators have demonstrated no differences based on race/ethnicity. 4,13,16,48 It is unclear why minorities might have lower adherence, but most have postulated that it is not race, but the interaction of race and income that is related to adherence. For example, Akincigil et al 95 studied long-term adherence to pharmacotherapy after acute myocardial infarction and reported the risk of discontinuation was highest among patients from low-income neighborhoods.…”