Older people and adherence with medication: A review of the literature

Banning, Maggi

doi:10.1016/j.ijnurstu.2008.02.009

Cited by 55 publications

(59 citation statements)

References 51 publications

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“…The positive influence of higher age on adherence in our analysis seems surprising at first as the adherence of older patients is often assumed to be suboptimal although it is not very well described in the literature (Banning 2008;Gellad et al 2011;Balkrishnan 1998), but is likely resulting from data collection that was done mostly online resulting in a median age of 51 years (in comparison to an estimated median age in Europe of 56 years at diagnosis (Hoffmann et al 2015)) with only 25% of the patients being older than 61 years. Only 7% (n = 189) were older than 70 and only 38 patients were older than 80 years.…”

Section: Discussionmentioning

confidence: 83%

Factors influencing adherence in CML and ways to improvement: Results of a patient-driven survey of 2546 patients in 63 countries

Geißler

Sharf

Bombaci³

et al. 2017

J Cancer Res Clin Oncol

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CML Advocates Network and were filled in by patients online and offline. Patient characteristics, treatment and motivations were collected. Adherence was assessed by the 8-item Morisky Medication Adherence scale. Logistic regression models were fitted to investigate the influence of different factors on adherence. Overall, 2 546 questionnaires from 63 countries and 79 CML patient organisations were evaluable. 32.7% of participants were highly adherent, 46.5% were in the medium and 20.7% in the low adherence group. Factors increasing the probability of being in the high adherence group are older age, male sex, management of side effects, only one tablet per day and feeling well informed about CML by the doctor. More than 2 years since diagnosis were significantly lowering the chance as was the use of reminding tools. Living arrangements, multiple medication and personal payment obligations increased the probability to be at least in the medium adherent group. This is the most comprehensive study conducted to date to gain knowledge about factors causing non-adherence in CML. Better information on the disease, medication and management of side effects, supported by haematologists, is key to improve adherence.

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Section: Discussionmentioning

confidence: 83%

Factors influencing adherence in CML and ways to improvement: Results of a patient-driven survey of 2546 patients in 63 countries

Geißler

Sharf

Bombaci³

et al. 2017

J Cancer Res Clin Oncol

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“…32 Even so, physicians may alter medication regimens and educate patients and their caregivers to manage complex treatment to enhance medication adherence. 33 Comorbidity was mentioned and rated by participating physicians as a relevant cause of hospitalization that is not avoidable, thereby echoing evidence from epidemiological studies. [34][35][36][37] This finding reflects the legitimate limitations of ambulatory care for some vulnerable highly complex patients.…”

Section: Strengths and Limitations Of The Studymentioning

confidence: 99%

Strategies for Reducing Potentially Avoidable Hospitalizations for Ambulatory Care-Sensitive Conditions

Freund

Campbell

Geissler

et al. 2013

The Annals of Family Medicine

148

129

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PURPOSE Hospitalizations for ambulatory care-sensitive conditions (ACSCs) are seen as potentially avoidable with optimal primary care. Little is known, however, about how primary care physicians rate these hospitalizations and whether and how they could be avoided. This study explores the complex causality of such hospitalizations from the perspective of primary care physicians. METHODSWe conducted semistructured interviews with 12 primary care physicians from 10 primary care clinics in Germany regarding 104 hospitalizations of 81 patients with ACSCs at high risk of rehospitalization. RESULTSParticipating physicians rated 43 (41%) of the 104 hospitalizations to be potentially avoidable. During the interviews the cause of hospitalization fell into 5 principal categories: system related (eg, unavailability of ambulatory services), physician related (eg, suboptimal monitoring), medical (eg, medication side effects), patient related (eg, delayed help-seeking), and social (eg, lack of social support). Subcategories frequently associated with physicians' rating of hospitalizations for ACSCs as potentially avoidable were after-hours absence of the treating physician, failure to use ambulatory services, suboptimal monitoring, patients' fearfulness, cultural background and insufficient language skills of patients, medication errors, medication nonadherence, and overprotective caregivers. Comorbidities and medical emergencies were frequent causes attributed to ACSC-based hospitalizations that were rated as being unavoidable.CONCLUSIONS Primary care physicians rated a significant proportion of hospitalizations for ACSCs to be potentially avoidable. Strategies to avoid these hospitalizations may target after-hours care, optimal use of ambulatory services, intensified monitoring of high-risk patients, and initiatives to improve patients` willingness and ability to seek timely help, as well as patients' medication adherence. Ann Fam Med 2013;363-370. doi:10.1370/afm.1498. INTRODUCTIONR educing the number of avoidable hospitalizations provides opportunities for reducing health care spending and improving both quality of care and quality of life. Avoidable hospitalizations are associated with high and rising costs, and they disrupt elective health care planning and affect patients' daily life. 1 In 1993 Billings et al categorized conditions according to their likelihood of being avoidable through timely and effective ambulatory care, including specialized ambulatory care in many countries such as Germany and the United States.2 Hospitalizations for ambulatory care-sensitive conditions (ACSCs) are potentially avoidable by preventing the onset of disease, controlling an acute episodic illness, or managing a chronic condition effectively.2 Since the 1990s different sets of ACSCs have been described in the United States, United Kingdom, Spain, and other countries with the aim of reducing avoidable hospitalizations by optimal ambulatory-particularly primary-care. R EDUCING HOSPITA L IZ AT IONS F OR A MBUL ATORY C A R E COND...

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“…A review of qualitative research proposed that three phases of decision making are important regarding medication adherence in older people: faith in the prescriber's ability to correctly diagnose and select treatment; testing of the effectiveness of the medication on symptom relief and adverse effects, and patients' beliefs about the illness itself [37]. Any one of these can influence attitudes to treatment and adherence.…”

Section: Determinants Of Non-adherence In Admentioning

confidence: 99%

Adherence to Cholinesterase Inhibitors in Alzheimer's Disease: A Review

Brady

Weinman

2013

Dement Geriatr Cogn Disord

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Background/Aims: Treatment adherence is a major problem in numerous medical conditions, and is a particular challenge in patients with Alzheimer's disease (AD). Methods: This non-systematic review summarises the current literature on factors that affect adherence to cholinesterase inhibitors, the mainstay of AD treatment. Articles listed on PubMed and published during the last 10 years were included. Results: Intentional factors affecting adherence include patient, caregiver and prescriber beliefs about therapies and the disease itself. Unintentional factors include tolerability, physical limitations of the patient and caregiver burden. Interventions aiming to improve adherence include educational programmes and new drug delivery methods. Conclusion: Due to the high level of caregiver involvement in the care of patients with AD, strategies that address caregiver concerns may improve adherence.

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Older people and adherence with medication: A review of the literature

Abstract: Background: Older people represent a sizeable population of the UK. Many older people

Cited by 55 publications

References 51 publications

Factors influencing adherence in CML and ways to improvement: Results of a patient-driven survey of 2546 patients in 63 countries

Factors influencing adherence in CML and ways to improvement: Results of a patient-driven survey of 2546 patients in 63 countries

Strategies for Reducing Potentially Avoidable Hospitalizations for Ambulatory Care-Sensitive Conditions

Adherence to Cholinesterase Inhibitors in Alzheimer's Disease: A Review

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