Regimen complexity and medication nonadherence in elderly patients
Andrea Corsonello1, Claudio Pedone3, Fabrizia Lattanzio2, Maria Lucchetti2, Sabrina Garasto1, Claudia Carbone1, Cosetta Greco2, Paolo Fabbietti2, Raffaele Antonelli Incalzi3
1Istituto Nazionale di Ricovero e Cura per Anziani (INRCA), Cosenza; 2Ancona, Italy; 3Cattedra di Geriatria, Università Campus BioMedico, Rome, Italy; 4Fondazione San Raffaele, Cittadella della Carità, Taranto, Italy
Objective: To assess whether the number of daily administrations of individual drugs, as a measure of regimen complexity, contributes to the profile of an elderly patient who adheres poorly to the prescribed therapy.
Population: Six hundred ninety patients over 64 years who were consecutively admitted to 11 acute medical care and three long term/rehabilitation wards in Italy.
Main outcome measure: Self-reported adherence to drugs taken at home before admission was measured by a single question assessment for each listed drug supplemented with a latter question about the circumstances of the missed administration. For cognitively impaired patients the question was put to patients' relatives or caregivers.
Methods: A structured multidimensional assessment was performed to identify nonadherence and its potential correlates. Correlates of nonadherence were identified by multivariable logistic regression.
Results: We recorded 44 cases (6.4%) of nonadherence to at least one drug. Being assisted by foreign caregivers (OR 2.17; 95% CI 1.02–4.63) and the use of at least one multiple daily dosing drug (OR 2.99; 95% CI 1.24–7.17) were significant independent correlates of medication nonadherence, while age, selected indexes of frailty and the cumulative number of prescribed drugs were not.
Conclusion: Regimen complexity and type of assistance are independent correlates of medication nonadherence.
Keywords: elderly, medication adherence, regimen complexity
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