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Regimen complexity and medication nonadherence in elderly patients

Authors Corsonello A, Pedone C, Lattanzio F, Lucchetti M, Garasto S, Carbone C, Greco C, Fabbietti P, Incalzi R

Published 26 February 2009 Volume 2009:5 Pages 209—216


Review by Single-blind

Peer reviewer comments 3

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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