Adherence to Medication in Older Adults with Type 2 Diabetes Living in Lubuskie Voivodeship in Poland: Association with Frailty Syndrome

Abstract

Purpose: Diabetic patients aged 65 years or older are more likely to be frail than non-diabetic older adults. Adherence to therapeutic recommendations in the elderly suffering from diabetes and co-existent frailty syndrome may prevent complications such as micro- or macroangiopathy, as well as significantly affect prevention and reversibility of frailty. The study aimed at assessing the impact of frailty syndrome (FS) on the level of adherence to medication in elderly patients with type 2 diabetes (DM2). Patients and Methods: The research was carried out among 175 DM2 patients (87; 49.71% women and 88; 50.29% men) whose average age amounted to 70.25 ± 6.7. Standardized research instruments included Tilburg frailty indicator (TFI) to assess FS and adherence in chronic disease scale questionnaire (ACDS) to measure adherence to medications. Results: The group of 101 (57.71%) patients displayed medium, 39 (22.29%)—low, and 35 (20.00%)—high adherence. As many as 140 of them (80.00%) were diagnosed with frailty syndrome. The median of the average result of TFI was significantly higher in the low adherence group (p ˂ 0.001) (Mdn = 9, Q1–Q3; 7–10 pt.) than in the medium (Mdn = 6, Q1–Q3; 5–9 pt.) or high adherence (Mdn = 6.00, Q1–Q3; 4.5–8 pt.) ones. The independent predictors of the chance to be qualified to the non-adherence group included three indicators: TFI (OR 1.558, 95% CI 1.245–1.95), male gender (OR 2.954, 95% CI 1.044–8.353), and the number of all medications taken daily (each extra pill decreased the chance of being qualified to the non-adherence group by 15.3% (95% CI 0.728–0.954). Conclusion: Frailty syndrome in elderly DM2 patients influenced medical adherence in this group. The low adhesion group had higher overall TFI scores and separately higher scores in the physical and psychological domains compared to the medium and high adhesion groups.

Self-Care Practices and Drivers of Anti-Diabetic Type 2 Medication Non-Compliance among Patients Accessing Healthcare at a Health Facility in Ghana

“…Available evidence had also revealed that age and sex had a significant relationship to anti-diabetic medication non-adherence and this also supports the outcome of this current study [36]. In addition, it is reported by a cross-sectional survey conducted in Poland that, adults aged 65 years and above do not comply with their medication and therefore suffer complications and as such do not relate well [37].…”

Adherence to treatment and quality of life of patients with hypertension during the COVID-19 pandemic

“…It is worth noting that elderly people with chronic diseases usually take several different types of medications, e.g in our study about 59% of the subjects had additional chronic diseases in addition to hypertension (multimorbidity phenomenon), and the average number of daily medications taken by a patient was 3.55 ±2.78. Correlation analysis did not show a significant relationship between the number of medications taken by patients and the level of adherence (p = 0.062), although other studies show that polypharmacy may worsen the adherence of elderly people with chronic diseases [29,30] and may contribute to adverse events such as falls [31].…”

Factors Associated with Medication Adherence among Community-Dwelling Older People with Frailty and Pre-Frailty in China

“…Overall, our results indicated that advanced age, marital status, smoking status, and functional ability were correlated with medication adherence amongst older adults who were pre-frail, while advanced age was found to have a significantly link among frail older adults. Over the years, few studies have examined factors associated with medication adherence with an emphasis placed on older people with frailty and pre-frailty, while age, gender, and education level have been related to medication adherence in patients who have diabetes, hypertension, and tumor [ 14 , 15 , 29 ]. The present study demonstrated that factors including gender, residence, and depressive symptoms were related to medication adherence for both groups, while these variables were not significantly related.…”

“…In recent years, much emphasis has been placed on medication regimens among older people challenged by comorbidities such as diabetes, hypertension, and tumor [ 14 , 15 , 16 , 17 , 18 , 19 ]. Nonetheless, research that specifically determines barriers and facilitators to influence the development of medication adherence in frail or pre-frail older people, has been largely understudied.…”