Association of Self-Reported Medication Adherence with Potentially Inappropriate Medications in Elderly Patients: A Cross-Sectional Pilot Study

Abstract

Background: Polypharmacy (PP) and potentially inappropriate medications (PIMs) cause problematic drug-related issues in elderly patients; however, little is known about the association between medication adherence and PP and PIMs. This study evaluated the association of self-reported medication adherence with PP and PIMs in elderly patients. Methods: A cross-sectional pilot study was conducted using data collected from electronic medical records of 142 self-administering patients aged ≥65 years, excluding emergency hospitalization cases. Self-reported medication adherence was assessed using the visual analogue scale (VAS). Results: Of the 142 patients, 91 (64.1%) had PP and 80 (56.3%) used at least one PIM. In univariate analysis, patients with a VAS score of 100% had a significantly higher number of female patients and ≥1 PIM use compared to other patients. We found no association between the VAS score and PP. In multivariable analysis, the use of PIMs was significantly associated with a VAS score of 100% (odds ratio = 2.32; 95% confidence interval = 1.16–4.72; p = 0.017). Conclusions: Use of PIMs by elderly patients is significantly associated with self-reported medication adherence. Pharmacists should pay more attention to prescribed medications of self-administering elderly patients in order to improve their prescribing quality.

Risk factors for self-reported medication adherence in community-dwelling older patients with multimorbidity and polypharmacy: a multicenter cross-sectional study

“…Only 50% of older patients who suffered from chronic diseases followed the treatment recommendations, and the rate was even lower in Asia, according to the 2013 WHO report [ 29 ]. The medication adherence rate in our study was 68.82%, higher than in similar studies conducted in China and other Asian countries, with reported rates of 32.6–45% [ 13 , 23 , 30 , 31 ]. The differences are related to the study population and the adherence assessment tools.…”

“…However, the results of this study indicate the opposite. A Japanese study showed that the use of PIM by older patients was significantly associated with self-reported medication adherence [ 23 ]. The reason may be related to the study population.…”

“…Almost 90% of the study subjects could self-administer their medications. Patients who can self-administer their medications may have been educated and proactively monitored by physicians or pharmacists to prevent ADE or worsening outcomes [ 23 ]. Furthermore, the study subjects were motivated to take medications, as shown by the high median VAS score of 88.…”

“…Few studies have been conducted on medication nonadherence in older patients with multimorbidity and polypharmacy [ 23 , 24 ]. This study aimed to evaluate the associations between patient characteristics, drug-related factors, and medication adherence in community-dwelling older patients with polypharmacy and chronic diseases.…”

Factors Associated with Self-reported Medication Adherence in Japanese Community-dwelling Elderly Individuals: The Nakajima Study

“…In our study, the median VAS score was 99％, which was high and similar to the results of previous studies which used VAS to evaluate medication adherence among Japanese elderly. 17) However, there is a possibility that these results may be overestimated because of the variation between subjective and objective evaluations. 18,19) The cut-oŠ point for medication adherence using VAS was 80 100％ in previous studies 17,20 25) and is generally 80％; however, this threshold is not always appropriate as it has been arbitrarily deˆned 26) and varies for diŠerent diseases.…”