Irshaidat Shayma, Gustafsson Maria, Norberg Helena
Department of Integrative Medical Biology, Umeå University, 901 87, Umeå, Sweden.
Drugs Real World Outcomes. 2023 Mar;10(1):23-29. doi: 10.1007/s40801-023-00352-8. Epub 2023 Jan 26.
Poor medication adherence is prevalent among older people. To optimize therapeutic outcomes, it is crucial to understand the underlying causes and perceptions.
We aimed to investigate the extent of self-reported medication adherence and associated factors among older people admitted to hospital.
Individuals living at home aged ≥ 75 years with an emergency admission at a university hospital between September 2018 and September 2021 were included. Participants answered the Medication Adherence Report Scale (MARS-5) questionnaire upon admission regarding their prescribed long-term medications. Participants with a MARS-5 score of 23-25 were defined as adherent and with a score of 5-22 as nonadherent. A multivariable logistic regression analysis was performed to investigate possible factors independently associated with self-reported medication adherence.
A total of 261 individuals were included. The mean age was 84 years (standard deviation 5.7) and the mean MARS-5 score was 23.9 (standard deviation 1.8). Overall, 227 (87%) participants were classified as adherent to their prescribed treatment, while 34 (13%) participants were classified as nonadherent. Participants with cognitive impairment (odds ratio = 0.40, 95% confidence interval 0.18-0.90, p = 0.027) and depression (odds ratio = 0.29, 95% confidence interval 0.10-0.87, p = 0.028) had a lower odds of reporting adherence to their medications.
The majority of individuals aged ≥ 75 years who were recently hospitalized rated themselves as adherent to their prescribed medications according to MARS-5. Future studies would benefit from adding more possible explanatory factors and combining a self-reported assessment with a more objective measurement of medication adherence.
老年人中药物治疗依从性差的情况很普遍。为了优化治疗效果，了解其潜在原因和认知至关重要。
我们旨在调查住院老年人自我报告的药物治疗依从性程度及相关因素。
纳入2018年9月至2021年9月期间在某大学医院因急诊入院、年龄≥75岁且居家生活的个体。参与者入院时就其处方的长期药物回答药物治疗依从性报告量表（MARS-5）问卷。MARS-5得分23 - 25分的参与者被定义为依从，得分5 - 22分的参与者被定义为不依从。进行多变量逻辑回归分析以调查与自我报告的药物治疗依从性独立相关的可能因素。
共纳入261名个体。平均年龄为84岁（标准差5.7），平均MARS-5得分为23.9（标准差1.8）。总体而言，227名（87%）参与者被分类为对其处方治疗依从，而34名（13%）参与者被分类为不依从。有认知障碍的参与者（比值比 = 0.40，95%置信区间0.18 - 0.90，p = 0.027）和有抑郁症的参与者（比值比 = 0.29，95%置信区间0.10 - 0.87，p = 0.028）报告药物治疗依从性的几率较低。
根据MARS-5，大多数最近住院的75岁及以上个体将自己评为对其处方药物依从。未来的研究若能增加更多可能的解释因素，并将自我报告评估与更客观的药物治疗依从性测量相结合，将会有所助益。
