Risk factors for self-reported medication adherence in community-dwelling older patients with multimorbidity and polypharmacy: a multicenter cross-sectional study.
Jiaming Liu, Yongpei Yu, Suying Yan, Yan Zeng, Su Su, Tiantian He, Zimin Wang, Qian Ding, Ruixue Zhang, Wenchao Li, Xin Wang, Lan Zhang, Xiaolin Yue
Author Information
Jiaming Liu: Department of Pharmacy, Xuanwu Hospital, Capital Medical University, Beijing, China.
Yongpei Yu: Department of Biostatistics, Peking University Clinical Research Institution, Beijing, China.
Suying Yan: Department of Pharmacy, Xuanwu Hospital, Capital Medical University, Beijing, China.
Yan Zeng: Department of Pharmacy, Xuanwu Hospital, Capital Medical University, Beijing, China.
Su Su: Department of Pharmacy, Xuanwu Hospital, Capital Medical University, Beijing, China.
Tiantian He: Department of Biostatistics, Peking University Clinical Research Institution, Beijing, China.
Zimin Wang: Department of Pharmacy, Xuanwu Hospital, Capital Medical University, Beijing, China.
Qian Ding: Department of Pharmacy, Xuanwu Hospital, Capital Medical University, Beijing, China.
Ruixue Zhang: Department of Pharmacy, Xuanwu Hospital, Capital Medical University, Beijing, China.
Wenchao Li: Department of Pharmacy, Xuanwu Hospital, Capital Medical University, Beijing, China.
Xin Wang: Department of Medical Affairs, Xuanwu Hospital, Capital Medical University, Beijing, China.
Lan Zhang: Department of Pharmacy, Xuanwu Hospital, Capital Medical University, Beijing, China.
Xiaolin Yue: Ethics Committee, Xuanwu Hospital, Capital Medical University, Beijing, China. yxl@xwhosp.org.
BACKGROUND: Medication nonadherence is a significant public health problem as it contributes to poor clinical outcomes and increased healthcare costs. Older patients with multimorbidity and polypharmacy often have low medication adherence. These patients also have a high prevalence of potentially inappropriate medication (PIM) use. AIM: To explore risk factors related to medication nonadherence in older patients with multimorbidity and polypharmacy and examine the association between medication nonadherence and PIM use. METHOD: A multicenter cross-sectional study was conducted from May to December 2019 in 16 tertiary hospitals from 12 provinces and cities in China. Data were collected from outpatients 65 years or older with multimorbidity and polypharmacy. The PIMs were evaluated using the 2019 Beers Criteria. Self-reported medication adherence was assessed using the Visual Analog Scale (VAS). RESULTS: A total of 773 outpatients were recruited. The prevalence of medication nonadherence was 31.8%. In the univariate analysis, nonadherence was significantly associated with sex, cognitive impairment, stroke, visiting the same physicians, self-administration of medication, the percentage of drug costs ≥ 10% of the medical expenses, and PIMs for the alimentary tract and metabolism. In the multivariate analysis, the results almost paralleled those of the univariate associations. Notably, the use of PIM was significantly associated with medication adherence. CONCLUSION: Several factors that influence medication adherence were identified. Targeted interventions can be implemented to improve medication adherence, such as encouraging self-administering medications and reducing medication expenses.
