A study of medication compliance in geriatric patients with chronic illness

Abstract

Introduction: Adherence is a multifactorial phenomenon. Usually geriatric patients will have multiple co morbidities because of which poly pharmacy results. This can adversely affect medication compliance. The purpose of our study is to identify various factors responsible for low medication compliance. Elderly people are usually affected with chronic illnesses like Hypertension, Diabates Mellitus, Dyslipidemia, Coronary artery diseases, Osteoarthritis, etc., All these diseases require long-term treatment. So, medication compliance is a very important factor which increases therapeutic outcome. Materials and Methods: The study subjects were assessed by using 15 item structured questionnaires as per indigenously modified Morisky Medication Adherence Scale (MMAS). Results: A total of 100 patients of geriatric age group were assessed for the level of compliance for long term medication. The compliance level was assessed by providing a 15-item structured questionnaire as per indigenously modified MMAS. The level of compliance was high in 82%, medium in 16% and low in 2% in the first visit. The level of compliance was again assessed during next review visit. The level of score during review visit was high in 74%, medium in 25% and low in 1%. Conclusion: The compliance to medication is adversely affected by complicated regimes, ignorance about the disease and complications, physical and economic problems. Geriatric patients especially have a tendency to stop taking drugs off their own when they consider their symptoms have been ameliorated. This can hinder the expected improvement in adherence in the review visit

Modern technologies for improving elderly patients’ compliance

“…Progressive multimorbidity means that elderly patients often have to adhere to multiple overlapping drug regimens involving long-term or even indefinite medication protocols. Such chronic polypharmacy is likely to adversely affect patients' adherence [32]. elderly patients' compliance with medication regimes tends to be decreased by the complexity of some schemes [32], especially when patients are less well educated [33], are ignorant of the disease or its complications [34] and are less aware of the treatment's nature [35] or justification [32,33]; additionally, coexisting dementia [36], cognitive [37] or other functional impairments, disability [32] and economic problems [32,38] often translate into unfilled prescriptions [39].…”

“…Such chronic polypharmacy is likely to adversely affect patients' adherence [32]. elderly patients' compliance with medication regimes tends to be decreased by the complexity of some schemes [32], especially when patients are less well educated [33], are ignorant of the disease or its complications [34] and are less aware of the treatment's nature [35] or justification [32,33]; additionally, coexisting dementia [36], cognitive [37] or other functional impairments, disability [32] and economic problems [32,38] often translate into unfilled prescriptions [39]. Besides low socioeconomic status [40], there are negative effects that arise from the lack of family or social support [41] or the lack of regular follow-up visits by the physician [42].…”

“…Selfmedication with over-the-counter drugs or home remedies [43], as well as participation in complementary or alternative medicine, may cause patients to disobey the physician's directions for therapy [44]. A lack of compliance is likely to be observed, especially in cases when the patient suffers from adverse effects of treatment [33] or where some degree of improvement of symptoms has already been achieved, giving the patient the subjective perception that the leading ailments have been to some extent alleviated [32]. Surprisingly, problems with therapy regime compliance are not only common in less-symptomatic chronic diseases, such as diabetes [45], hypertension [46], metabolic syndrome [47] and osteoporosis [48], but also in conditions where demonstrable symptoms prevail, such as asthma [49] and chronic pain [50].…”

Transitional care for older adults with chronic illness: A qualitative inquiry

“…Medication compliance in older adults with chronic illness is adversely affected by complicated regimes, ignorance about disease and complications and physical and economic problems. As symptoms diminish, older adults tend to discontinue their prescribed medications (Punnapurath et al., 2021). A cross‐sectional study done among 400 community‐dwelling older adults with non‐communicable diseases in South India informs that medication compliance improves with proper guidance and education.…”

Grado de cumplimiento de las indicaciones médicas por parte de los pacientes

“…En este trabajo realizado en una población de pacientes jubilados, hemos observado que la indicación médica que con mayor frecuencia no se cumplió fue la relacionada a la medicación y esto se debió en todos los casos a la falta de autorización de la cobertura por su sistema de cobertura de salud (obra social). Estos hallazgos se relacionan con los resultados de un estudio que evaluaba el nivel de cumplimiento de la medicación a largo plazo en pacientes geriátricos que concluye que la adherencia a la medicación se ve afectada negativamente por problemas económicos (Punnapurath et al, 2021).…”