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Medication adherence and knowledge in older patients

Published online by Cambridge University Press:  13 June 2014

Richard Cahill*
Affiliation:
St. Brigid's Hospital, Ardee, Co Louth
Kieron O'Loughlin
Affiliation:
General Adult Psychiatry, St Vincent's University Hospital, Elm Park, Dublin 4
Gregory Swanwick
Affiliation:
Psychiatry of Later Life, Adelaide and Meath Hospital incorporating National Children's Hospital, Tallaght, Dublin 24
Siobhan Ni Bhriain
Affiliation:
Psychiatry of Later Life, Adelaide and Meath Hospital incorporating National Children's Hospital, Tallaght, Dublin 24.
*
*Correspondence E-mail: richardcahill37@eircom.net

Abstract

Objectives: To assess the degree to which a sample of older individuals – who are engaged with psychiatric services – are knowledgeable about their medication and the reason for its prescription; to assess the degree to which these patients adhere to what is prescribed.

Methods: Convenience sample of 24 patients over 65 years old, under the care of psychiatric services for Later Life, included. Patients who scored < 23 on Mini-mental State Examination were excluded. A questionnaire was administered which evaluated patients' knowledge of the names of, and reasons for, all prescription medications. Adherence rates were measured. Comparisons were made regarding to self-reported adherence rates and medication knowledge. These were based on diagnosis, age, number of medications prescribed and the presence or absence of sensory impairment.

Results: The median percentage of medication names recalled was 60%. A total of 25% of patients reported having some problem with adherence. No patient with a diagnosis of dementia was able to recall the names of, or reasons for, all medications prescribed. Patients with depression and dementia were as likely to be fully adherent as the total sample. Patients (a) aged 78 years or more and (b) those who were on more than six medications – were less knowledgeable about and less likely to adhere to prescribed drug regimens. We did not identify an association between reduced visual acuity and reduced medication adherence

Conclusion: Patients require ongoing education concerning all aspects of medication, especially the reasons for prescription. Older patients and those receiving more complex regimens may be at particular risk of adherence problems.

Type
Brief Report
Copyright
Copyright © Cambridge University Press 2010

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References

1.Di Matteo, MR, Giordani, Rl, Lepper, HS, Croghan, TW. Patient adherence and medical outcomes; a meta-analysis. Med Care 2002; 40: 794811.CrossRefGoogle ScholarPubMed
2.Rogers, PG, Bullman, R. Prescription medicine compliance; a review of the baseline of knowledge: a report of the national council on patient information and education. Binghampton (NY); The Haworth Press, 1995:; 337.Google Scholar
3.German, PS, Klein, LE, McPhee, SJet al.Knowledge of and compliance with drug regimens in the elderly. J Am Geriatr. Soc 1982; 30(9): 568–71.CrossRefGoogle ScholarPubMed
4.Ruscin, JM, Semla, TP. Assessment of medication management skills in older out-patients. Ann Pharmacother 1996; 30: 1083–8.CrossRefGoogle Scholar
5.Coons, SJ, Sheahan, SL, Martin, SSet al.Predictors of medication non-compliance in a sample of older adults. Clin Ther 1994; 16: 110–7.Google Scholar
6.Di Matteo, MR, Lepper, HS, Croghan, TW. Depression is a risk factor for non-compliance with medical treatment; meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 2000; 160: 2101–7.CrossRefGoogle Scholar
7.Park, DC, Morrell, RW, Frieske, Det al.Medication adherence behaviors in older adults: effects of external cognitive supports. Psychol Aging 1992; 7: 252–6.CrossRefGoogle ScholarPubMed
8.Monane, M, Bohn, RL, Gurwitz, JHet al.Compliance with antihypertensive therapy among medical enrollees: the role of age, gender and race. Am J Public Health 1996; 86: 1805–8.CrossRefGoogle Scholar
9.Fedder, DO. Drug use in the elderly: issues of non-compliance. Drug Intell Clin Pharm 1984; 18: 158–62.Google Scholar
10.Billups, SJ, Malone, DC, Carter, BL. The relationship between drug therapy non-compliance and patient characteristics, health related quality of life and health care costs. Pharmacotherapy 2000; 20: 941–9.CrossRefGoogle Scholar
11.Ryan, AA. Medication compliance and older people: a review of the literature. Int J Nurs Stand 1999; 36(2): 153–62.CrossRefGoogle ScholarPubMed
12.Beisecker, AE. Older persons' medical encounters and their outcomes. Res Aging 1996; 18(1): 931.CrossRefGoogle Scholar
13.Di Matteo, MR, Robinson, JD, Heritage, Jet al.Correspondence among patients' self reports, chart records and audio/video tapes of medical visits. Health Commun 2002; 15: 2.Google Scholar