Medication adherence and related determinants in older people with multimorbidity: A cross‐sectional study

Abstract

Aim Identify the medication adherence determinants in older adults with multimorbidity and polypharmacy. Materials and Methods A cross‐sectional study was conducted in a non‐probabilistic sample of 245 adults ≥65 years recruited in a general medical ward of one teaching hospital. Data were collected during hospital stay using a face‐to‐face interview based on a set of validated questionnaires, such as the measure treatment adherence, the beliefs about medicines questionnaire‐specific and the geriatric depression scale. Descriptive and multiple linear regression analysis were performed. Results Participants' mean age was 78.32 (SD: 6.95) years and 50.6% were women. Older adults lived with an average of 7.51 (SD: 1.95) chronic conditions and had a mean of 7.95 (min. 4; max. 18) medications prescribed. The proportion of older adults adherent to medication was 43.7%. Depression ( β = −0.142; p = 0.031), beliefs about treatment necessity ( β = 0.306; p = 0.001) and concerns about the medication ( β = −0.204; p = 0.001) were found as independent determinants of adherence. Conclusion Self‐reported medication non‐adherence appears to be common in older adults with multimorbidity and polypharmacy. Depression, necessity and concerns should be considered when assessing medication non‐adherence in practice. This study will also contribute to develop an intervention to manage adherence in older people, as part of a doctoral research project.

Patterns and Determinants of Multimorbidity in Older Adults: Study in Health-Ecological Perspective

“…Interestingly, at the lifestyle behavior layer, our study found that a low medication adherence was a risk factor, while a moderate medication adherence was a protective factor for developing multimorbidity. The former was consistent with previous views [ 56 ], while the latter was probably due to our data being cross-sectional and could not determine causality between the variables, whereas older people with a high medication adherence tended to be those who were already suffering from disease or even multimorbidity [ 57 ], which is consistent with Domino’s study, which concluded that there was a lower non-adherence among patients with multimorbidity [ 58 ]. Older adults with lower levels of physical activity are more likely to suffer from multimorbidity.…”

Medication Adherence Among Geriatric Patients with Chronic Diseases in Riyadh, Saudi Arabia

“…It is estimated that around 10% of geriatrics hospitalizations are due to medication nonadherence, 9 and the rate of non-adherence in older adults as high as 75%. 10 The World Health Organization (WHO) has identified multifactorial determinants that influence adherence, categorizing them into five dimensions: patient-related factors, socioeconomic factors, therapy-related factors, condition-related factors, health care team, and system-related factors. 8 Further studies show that the most influencing barriers found between the elderly were beliefs about treatment necessity, regimens complexity, and concerns regarding potential side effects.…”

“…8 Further studies show that the most influencing barriers found between the elderly were beliefs about treatment necessity, regimens complexity, and concerns regarding potential side effects. 10 Assessment of the patients' compliance with the treatment regimen is crucial. However, there is no standard method for assessing medication adherence.…”

Medication Adherence: Fact or Fictions?

“…Three-quarters of elderly patients worldwide are unable to adhere to appropriate long-term treatment regimens-due to multiple physical complications and additional medication burden [22]. Elderly patients taking at least 5 medications are at increased risk of mild cognitive impairment, dementia, falls, frailty, disability, and mortality, while ADEs are estimated to be 5% to 28% of acute geriatric medical admissions [23,24].…”