K Jeyalakshmi, Rao Mahadev, Yn Shashidhara, Thunga Girish, N Ravishankar, Sudhakar Christopher, Sanatombi Devi Elsa
Department of Community Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Patient Prefer Adherence. 2023 Jul 13;17:1641-1656. doi: 10.2147/PPA.S380784. eCollection 2023.
Medication adherence is a crucial component in the management of elderly with co-morbid chronic conditions. Hence, this study aimed to investigate the determinants of medication non-adherence among rural elderly with co-morbid chronic conditions of hypertension (HTN) and type 2 diabetes mellitus (T2DM) in India.
This cross-sectional study adopted the probability proportional to size (PPS) sampling technique to find the determinants of medication non-adherence among elderly residing in rural coverage areas of five randomly selected primary health centres (PHC) in Udupi district, Karnataka, India. A total of 360 elderly (72 samples from each cluster) who met the inclusion criteria and consented were interviewed using predesigned prevalidated and standardized or reliable tools. The data were coded and entered in SPSS version 16.0 and analyzed using both descriptive and inferential statistics.
The study found that 55.6% (n=200) of rural elderly with co-morbid conditions HTN and T2DM were non-adherent to their medications and established Spearman correlation coefficient rank () value between undesirable person-related factors (=-0.444); good family support (including financial support) (=0.185); poor accessibility to healthcare facility (=-0.209); detrimental medication-related factors including high cost of medication (=-0.237) were found to be significant at 0.05 level of confidence (p < 0.05). Further, the study depicted that the chi-square test () was identified to be significantly associated (p<0.05) with a variable such as education, knowledge, number of illnesses and impairments, vision, memory, and physical impairments.
Medication adherence could be improved among rural elderly with co-morbid conditions by identifying and addressing the determinants at the earliest. Further, it is vital to identify the suitable intervention program to address these avoidable problems.
药物依从性是患有多种慢性疾病的老年人管理中的关键组成部分。因此，本研究旨在调查印度农村地区患有高血压（HTN）和2型糖尿病（T2DM）等多种慢性疾病的老年人药物不依从的决定因素。
本横断面研究采用按规模大小成比例的概率抽样技术，以找出印度卡纳塔克邦乌度皮区五个随机选择的初级卫生保健中心（PHC）农村覆盖地区老年人药物不依从的决定因素。共有360名符合纳入标准并同意参与的老年人，使用预先设计、预先验证且标准化或可靠的工具进行了访谈。数据进行编码并录入SPSS 16.0版本，使用描述性和推断性统计进行分析。
研究发现，患有HTN和T2DM等多种疾病的农村老年人中，55.6%（n = 200）不依从药物治疗，并确定了不良的个人相关因素（=-0.444）、良好的家庭支持（包括经济支持）（=0.185）、医疗保健设施可及性差（=-0.209）、包括药物成本高在内的有害药物相关因素（=-0.237）在0.05的置信水平上具有显著意义（p < 0.05）。此外，研究表明卡方检验（）与教育、知识、疾病和损伤数量、视力、记忆力和身体损伤等变量显著相关（p<0.05）。
通过尽早识别并解决决定因素，可提高患有多种疾病的农村老年人的药物依从性。此外，确定合适的干预方案以解决这些可避免的问题至关重要。
