Daily Medication Management and Adherence in the Polymedicated Elderly: A Cross-Sectional Study in Portugal

Abstract

The presence of age-related comorbidities prone elderly patients to the phenomenon of polypharmacy and consequently to a higher risk of nonadherence. Thus, this paper aims to characterize the medication consumption profile and explore the relationship of beliefs and daily medication management on medication adherence by home-dwelling polymedicated elderly people. A questionnaire on adherence, managing, and beliefs of medicines was applied to polymedicated patients with ≥65 years old, in primary care centers of the central region of Portugal. Of the 1089 participants, 47.7% were considered nonadherent. Forgetfulness (38.8%), difficulties in managing medication (14.3%), concerns with side effects (10.7%), and the price of medication (9.2%) were pointed as relevant medication nonadherence-related factors. It was observed that patients who had difficulties managing medicines, common forgetfulness, concerns with side effects, doubting the need for the medication, considered prices expensive, and had a lack of trust for some medicines had a higher risk of being nonadherent. This study provides relevant information concerning the daily routine and management of medicines that can be useful to the development of educational strategies to promote health literacy and improve medication adherence in polymedicated home-dwelling elderly.

Operacionalização para Portugal da Lista EU(7)-PIM para Identificação de Medicamentos Potencialmente Inapropriados nos Idosos

“…A amostra inclui utentes de unidades de cuidados de saúde primários (faixa etária entre os 65 e os 99 anos), não institucionalizados. 25 O projeto obteve parecer favorável da Comissão de Ética da Administração Regional de Saúde do Centro (Parecer nº 105/2017) e autorização da Comissão Nacional de Proteção de Dados (Autorização n.º 13028/ 2017). A recolha de dados sobre os medicamentos utilizados pela população idosa decorreu entre abril e agosto de 2019, em 38 unidades de cuidados de saúde primários da região centro.…”

The Use of Antidepressants, Anxiolytics, Sedatives and Hypnotics in Europe: Focusing on Mental Health Care in Portugal and Prescribing in Older Patients

“…The prescription of these drugs for older patients raises important concerns, as ageing and multimorbidity are usually associated with polypharmacy, where older patients take multiple medicines for long periods of their lives [ 18 , 19 , 20 ]. The use of multiple medications contributes to an inappropriate use of medicines, which can interfere with the effectiveness of treatments [ 18 ].…”

“…The prescription of these drugs for older patients raises important concerns, as ageing and multimorbidity are usually associated with polypharmacy, where older patients take multiple medicines for long periods of their lives [ 18 , 19 , 20 ]. The use of multiple medications contributes to an inappropriate use of medicines, which can interfere with the effectiveness of treatments [ 18 ]. According to the American Geriatrics Society’s Beers Criteria for Potentially Inappropriate Medications in the Elderly, the prescription of these drugs for older patients should be avoided, as they are associated to several adverse reactions and potential dangers [ 21 ].…”

“…Considering that anxiolytics and antidepressants are highlighted as some of the most frequent prescribed drugs for older patients and that there is currently no evidence that shows a reduction of this consumption patterns [ 16 , 18 ], the current study aims to critically evaluate the mental health care framework, providing an analysis confronting both mental health policies and drug consumption in Portugal. By analyzing the consumption of antidepressants, anxiolytics, sedatives and hypnotics across Europe and Portugal, with a special focus on the older population, this study expects to (1) provide a critical perspective on the mental health framework in Portugal and (2) shed light on the main risks associated with the use of anxiolytics, antidepressants, sedatives and hypnotics by older people, while critically analyzing the policies designed and implemented for the improvement of prescription practices.…”

Voices of Polymedicated Older Patients: A Focus Group Approach

“…When correctly handled, medicines are fundamental technologies for achieving better health outcomes [4,5]. The increased fragility of the older population can lead them to suffer the consequences of medication errors in the form of adverse drug effects or therapy failure, and ultimately increased morbidity and mortality [3,6]. In older people, factors such as polypharmacy, socio-economic conditions, and perceptions of disease and treatment also seem to be related to DRPs [7].…”