Effect of Potentially Inappropriate Medication on Treatment Adherence in Elderly with Chronic Illness
Supriya Pradhanand Abinash Panda2

1Department of Pharmacology, MKCG Medical College, Berhampur, Odisha 760004, India.

2Department of Pharmacology, Government Medical College and Hospital, Balasore, Odisha 756019, India.

Corresponding Author E-mail: drabinashpanda@rediffmail.com

Abstract: Non-adherence to treatment has been associated with poor clinical outcomes, especially in vulnerable population like, the elderly. In general, the adherence to medication and use of a potentially inappropriate medication (PIM) may range from 47 to 100% and 20 to 25% respectively, in elderly. PIM is associated with increased risk of adverse drug reactions (ADR) which is a recognized determinant of adherence. The present study was taken up with the primary objective of exploring the influence of potentially inappropriate medication on adherence to drug treatment in elderly patients with chronic illnesses. This cross-sectional study was carried out in the out-patient department of a tertiary care hospital, on a convenience sample of 425 elderly patients. Medication adherence was assessed using the Morisky Medication Adherence Scale. PIM was assessed as per the American Geriatric Society (AGS) Beers Criteria of 2015. Ordinal regression method was used to analyze the relationship between the ordinal outcome variable (adherence) and the explanatory variables. The study observed that about 48% of the elderly patients were found to be non-adherent to treatment. An inappropriate drug was prescribed in 23.8%. Elderly patients with a potentially inappropriate medication were twice likely be non-adherent to treatment than those without a PIM (OR: 2.089 with CI: 1.277-3.419, p = 0.003). The present study concluded that potentially inappropriate medication is an important predictor of medication adherence in elderly. Since, high adherence level to medication among patients is widely reported to be associated with higher treatment efficacy, identifying the factors that lead to poor medication adherence is essential for the success of a therapy. Prescribers should carefully assess the appropriateness of medications in elderly to improve their adherence to therapy.

Keywords: Adherence; Beers Criteria; Elderly; MMAS-8; Potentially Inappropriate Medication (PIM)

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