Factors Associated with Medication Non-Adherence among Patients with Multimorbidity and Polypharmacy Admitted to an Intermediate Care Center

International Journal of Environmental Research and Public Health

Joan Espaulella-Panicot¹  Daniel Sevilla-Sánchez¹  Núria Molist-Brunet¹  Emma Puigoriol-Juvanteny²  Javier González-Bueno³  Carles Codina-Jané³ 

[1] Central Catalonia Chronicity Research Group (C3RG), University of Vic—Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain;Epidemiology Unit, Consorci Hospitalari de Vic, 08500 Barcelona, Spain;Pharmacy Department, Consorci Hospitalari de Vic, 08500 Barcelona, Spain;

关键词: multimorbidity;    elderly;    polypharmacy;    inappropriate prescribing;    medication adherence;   

DOI  :  10.3390/ijerph18189606

来源: DOAJ

【 摘 要 】

Identifying determinants of medication non-adherence in patients with multimorbidity would provide a step forward in developing patient-centered strategies to optimize their care. Medication appropriateness has been proposed to play a major role in medication non-adherence, reinforcing the importance of interdisciplinary medication review. This study examines factors associated with medication non-adherence among older patients with multimorbidity and polypharmacy. A cross-sectional study of non-institutionalized patients aged ≥65 years with ≥2 chronic conditions and ≥5 long-term medications admitted to an intermediate care center was performed. Ninety-three patients were included (mean age 83.0 ± 6.1 years). The prevalence of non-adherence based on patients’ multiple discretized proportion of days covered was 79.6% (n = 74). According to multivariable analyses, individuals with a suboptimal self-report adherence (by using the Spanish-version Adherence to Refills and Medications Scale) were more likely to be non-adherent to medications (OR = 8.99, 95% CI 2.80–28.84, p < 0.001). Having ≥3 potentially inappropriate prescribing (OR = 3.90, 95% CI 0.95–15.99, p = 0.059) was barely below the level of significance. These two factors seem to capture most of the non-adherence determinants identified in bivariate analyses, including medication burden, medication appropriateness and patients’ experiences related to medication management. Thus, the relationship between patients’ self-reported adherence and medication appropriateness provides a basis to implement targeted strategies to improve effective prescribing in patients with multimorbidity.

【 授权许可】

Unknown