Non‐prescription medicines may contribute to non‐adherence to prescription medicines in people living with chronic health conditions

Anoopkumar‐Dukie, Shailendra; Mey, Amary; Hall, Susan; Bernaitis, Nijole; Davey, Andrew K.; Plummer, David

doi:10.1111/ijcp.13489

Cited by 9 publications

(8 citation statements)

References 42 publications

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“…health literacy), drug-related factors (e.g. adverse effects), the patient-provider relationship, difficulties of obtaining medications, and the use of non-prescription medications [ 48 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

The impact of high-risk medications on mortality risk among older adults with polypharmacy: evidence from the English Longitudinal Study of Ageing

Huang

Steptoe

Wei

et al. 2021

BMC Med

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Background Polypharmacy is common among older people and is associated with an increased mortality risk. However, little is known about whether the mortality risk is related to specific medications among older adults with polypharmacy. This study therefore aimed to investigate associations between high-risk medications and all-cause and cause-specific mortality among older adults with polypharmacy. Methods This study included 1356 older adults with polypharmacy (5+ long-term medications a day for conditions or symptoms) from Wave 6 (2012/2013) of the English Longitudinal Study of Ageing. First, using the agglomerative hierarchical clustering method, participants were grouped according to the use of 14 high-risk medication categories. Next, the relationship between the high-risk medication patterns and all-cause and cause-specific mortality (followed up to April 2018) was examined. All-cause mortality was assessed by Cox proportional hazards model and competing-risk regression was employed for cause-specific mortality. Results Five high-risk medication patterns—a renin-angiotensin-aldosterone system (RAAS) inhibitors cluster, a mental health drugs cluster, a central nervous system (CNS) drugs cluster, a RAAS inhibitors and antithrombotics cluster, and an antithrombotics cluster—were identified. The mental health drugs cluster showed increased risks of all-cause (HR = 1.55, 95%CI = 1.05, 2.28) and cardiovascular disease (CVD) (SHR = 2.11, 95%CI = 1.10, 4.05) mortality compared with the CNS drug cluster over 6 years, while others showed no differences in mortality. Among these patterns, the mental health drugs cluster showed the highest prevalence of antidepressants (64.1%), benzodiazepines (10.4%), antipsychotics (2.4%), antimanic agents (0.7%), opioids (33.2%), and muscle relaxants (21.5%). The findings suggested that older adults with polypharmacy who took mental health drugs (primarily antidepressants), opioids, and muscle relaxants were at higher risk of all-cause and CVD mortality, compared with those who did not take these types of medications. Conclusions This study supports the inclusion of opioids in the current guidance on structured medication reviews, but it also suggests that older adults with polypharmacy who take psychotropic medications and muscle relaxants are prone to adverse outcomes and therefore may need more attention. The reinforcement of structured medication reviews would contribute to early intervention in medication use which may consequently reduce medication-related problems and bring clinical benefits to older adults with polypharmacy.

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Section: Discussionmentioning

confidence: 99%

The impact of high-risk medications on mortality risk among older adults with polypharmacy: evidence from the English Longitudinal Study of Ageing

Huang

Steptoe

Wei

et al. 2021

BMC Med

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“…Patients with 0-1 comorbidity had higher medication adherence than patients with 2 or more comorbidities (p = 0.019). The results of previous studies also showed that people having multiple comorbidities and using multiple drugs at the same time often had a lower medication adherence [26,27]. This could be because patients with multiple comorbidities tend to use many drugs, making it challenging for them to manage their conditions and more likely to forget to use their medications more often.…”

Section: Discussionmentioning

confidence: 98%

Medication Adherence of Vietnamese Outpatients with Chronic Diseases during the COVID-19 Pandemic

et al. 2022

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The purpose of this study was to determine the medication adherence of outpatients with chronic diseases and the association between both patient attitudes and preventive practices regarding COVID-19 and their medication adherence. We performed a cross-sectional study in Vietnam. Medication adherence was determined using the translated and validated Vietnamese version of the General Medication Adherence Scale (GMAS). Patient attitudes and preventive practices regarding COVID-19 were measured using the 5K message of the Vietnam Ministry of Health (facemasks, disinfection, distance, no gatherings, health declarations). The associations between patient characteristics and medication adherence were determined by multivariable regression. The study included 1852 outpatients, and 57.6% of the patients adhered to their medications. Patients who recognized the pandemic’s obstruction of medical follow-ups (OR = 1.771; 95%CI = 1.461–2.147; p < 0.001), who applied ≥2 preventive methods (OR = 1.422; 95%CI = 1.173–1.725; p = 0.001), who were employed (OR = 1.677; 95%CI = 1.251–2.248; p = 0.001), who were living in urban areas (OR = 1.336; 95%CI = 1.090–1.637; p = 0.005,) who possessed higher education levels (OR = 1.313; 95%CI = 1.059–1.629; p = 0.013), or who had ≤2 comorbidities (OR = 1.293; 95%CI = 1.044–1.600; p = 0.019) were more likely to adhere to their medications. The adherence percentage for outpatients with chronic diseases was quite low during the pandemic. Patients who did not recognize the COVID-19 pandemic’s obstruction of medical follow-ups or who had poor preventive practices were less likely to adhere to medications. Healthcare providers should pay more attention to these groups to achieve desired treatment outcomes.

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“…Participants also reported using OTC treatments. While concurrent use of non‐prescription medications is reported as a barrier to adherence (Anoopkumar‐Dukie et al., 2020), there is a tendency among patients to withhold details of OTC drug use from their GP (Moen, Norrgård, Antonov, Nilsson, & Ring, 2010). Our results therefore highlight that the burden of medications is not restricted to long‐term prescribed treatments, and other medicines may contribute to challenges with adherence.…”

Section: Discussionmentioning

confidence: 99%

‘Just keep taking them, keep hoping they’ll work’: A qualitative study of adhering to medications for multimorbidity

Foley

Hynes

Murphy

et al. 2021

British J Health Psychol

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Objective. Compared to single diseases, health psychology reflects many areas of medical research by affording relatively less attention to the experiences of people selfmanaging multiple co-occurring conditions and, in particular, the experience of managing the associated complex medication regimens. This study aimed to explore the experience of self-managing multimorbidity among older adults, with a focus on medication adherence.Design. A qualitative approach was taken, using individual semi-structured interviews.Methods. Sixteen people with complex multimorbidity aged 65 years or older were recruited through general practice to take part in semi-structured interviews. Data were analysed following guidelines for reflexive thematic analysis.

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Non‐prescription medicines may contribute to non‐adherence to prescription medicines in people living with chronic health conditions

Cited by 9 publications

References 42 publications

The impact of high-risk medications on mortality risk among older adults with polypharmacy: evidence from the English Longitudinal Study of Ageing

The impact of high-risk medications on mortality risk among older adults with polypharmacy: evidence from the English Longitudinal Study of Ageing

Medication Adherence of Vietnamese Outpatients with Chronic Diseases during the COVID-19 Pandemic

‘Just keep taking them, keep hoping they’ll work’: A qualitative study of adhering to medications for multimorbidity

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