Non-Adherence in Seniors With Dementia – A Serious Problem of Routine Clinical Practice

Luzny, Jan; Ivanová, Kateřina; Juríčková, Ľubica

doi:10.14712/18059694.2014.43

Cited by 10 publications

(12 citation statements)

References 23 publications

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“…A relatively high medication adherence rate was observed among the subjects of the present study, in contrast to previous studies 1 , 2 , 6 , 7 , 8 , 9 , 10 ) . The presence of a doctor who knew all the kinds of medicines they were taking likely contributed to this high adherence.…”

Section: Discussioncontrasting

confidence: 99%

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Comprehensive medication management services influence medication adherence among Japanese older people

et al. 2015

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Objective: Assistance from health professionals is very important to ensure medication adherence among older people. The present study aimed to assess the relationship between receipt of comprehensive medication management services by primary care physicians and medication adherence among community-dwelling older people in rural Japan. Methods: Data including medication adherence and whether or not a doctor knew all the kinds of medicines being taken were obtained from individuals aged 65 years or older who underwent an annual health checkup between February 2013 and March 2014 at a public clinic in Asakura. The subjects were divided into 2 groups: adherent (always) and non-adherent (not always). A logistic regression analysis was performed to assess the association between the presence of a doctor who was fully responsible for medication adherence and self-reported adherence. Predictors that exhibited significant association (p-value < 0.05) with medication adherence in a univariate analysis were entered in the model as possible confounding factors. The results were presented as odds ratios (OR) and 95% confidence intervals (CI). Results: Among four-hundred ninety-seven subjects in total, the adherent group included 430 subjects (86.5%), and its members were older than those of the non-adherent group. Significant predictors of good medication adherence included older age, no discomforting symptoms, eating regularly, diabetes mellitus and having a doctor who knew all the kinds of medicines being taken. After being adjusted for confounding variables, the subjects with a doctor who knew all the kinds of medicines they were taking were three times more likely to be adherent to medication (OR 3.01, 95% CI 1.44-6.99). Conclusion: Receipt of comprehensive medication management services for older people was associated with medication adherence.

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Section: Discussioncontrasting

confidence: 99%

“…Thus, they have an increased risk of overlapping prescriptions or drug interactions 6 ) . Moreover, older people tend to present with cognitive 7 , 8 ) or swallowing 9 ) impairment, and they may need medication support to improve medication adherence 10 ) .…”

Section: Introductionmentioning

confidence: 99%

Comprehensive medication management services influence medication adherence among Japanese older people

et al. 2015

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“…This may be a reflection of worse overall health status or non-adherence to medication [34]. Even though the simple dosage of NOACs might prove more practical in this subgroup, the detection of overanticoagulation might be more difficult compared to warfarin treatment with regular INR controls.…”

Section: Discussionmentioning

confidence: 99%

Incidence and predictors of excessive warfarin anticoagulation in patients with atrial fibrillation—The EWA study

et al. 2017

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Vitamin K antagonist warfarin is widely used in clinical practice and excessive anticoagulation is a well-known complication of this therapy. Little is known about permanent and temporary predictors for severe overanticoagulation. The aim of this study was to investigate the occurrence and predicting factors for episodes with very high (≥9) international normalized ratio (INR) values in warfarin treated patients with atrial fibrillation (AF). Excessive Warfarin Anticoagulation (EWA) study screened all patients (n = 13618) in the Turku University Hospital region with an INR ≥2 between years 2003–2015. Patients using warfarin anticoagulation for AF with very high (≥9) INR values (EWA Group) were identified (n = 412 patients) and their characteristics were compared to a control group (n = 405) of AF patients with stable INR during long-term follow-up. Over 20% (n = 92) of the EWA patients had more than one event of very high INR and in 105 (25.5%) patients EWA led to a bleeding event. Of the several temporary and permanent EWA risk factors observed, strongest were excessive alcohol consumption in 9.6% of patients (OR 24.4, 95% CI 9.9–50.4, p<0.0001) and reduced renal function (OR 15.2, 95% CI 5.67–40.7, p<0.0001). Recent antibiotic or antifungal medication, recent hospitalization or outpatient clinic visit and the first 6 months of warfarin use were the most significant temporary risk factors for EWA. Excessive warfarin anticoagulation can be predicted with several permanent and temporary clinical risk factors, many of which are modifiable.

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“…(11) Medication non-compliance has critical negative implications on achieving optimal treatment outcome and indirectly imposes significant economic cost to the healthcare system. (12) In addition, medication non-compliance among AD patients was found to be associated with a higher risk of hospital admission. (13) As no local data on medication compliance in AD is available, this study aimed to identify the reasons for noncompliance to medications and estimate the time-point of treatment discontinuation among AD patients in Singapore.…”

Section: Introductionmentioning

confidence: 99%

Medication compliance in Singaporean patients with Alzheimer’s disease

Lum¹,

Suministrado²,

Venketasubramanian³

et al. 2019

smedj

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Non-Adherence in Seniors With Dementia – A Serious Problem of Routine Clinical Practice

Abstract: In conclusion, non-adherence to treatment in the studied group of seniors with dementia correlates with the severity of cognitive impairment - a higher cognitive decline correlates with a higher risk of non-adherence to treatment.

Cited by 10 publications

References 23 publications

Comprehensive medication management services influence medication adherence among Japanese older people

Comprehensive medication management services influence medication adherence among Japanese older people

Incidence and predictors of excessive warfarin anticoagulation in patients with atrial fibrillation—The EWA study

Medication compliance in Singaporean patients with Alzheimer’s disease

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