Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and Division of Geriatric Medicine, Helen Joseph Hospital, Johannesburg.
S Afr Fam Pract (2004). 2024 Oct 25;66(1):e1-e8. doi: 10.4102/safp.v66i1.6011.
Adherence to medication represents a challenge in managing chronic conditions in the geriatric population. This study assessed adherence rates and factors affecting adherence of geriatric patients attending the Helen Joseph Hospital outpatient department.
This was a prospective cross-sectional study of 130 patients aged 65 years and older, with at least two chronic conditions. Participants were administered a survey incorporating the Medication Adherence Rating Scale and the Adherence Barrier Questionnaire to identify medication adherence and patient-specific barriers to adherence, respectively. These instruments are reliable and valid.
Descriptive statistics and logistic regression were used for analysis. Most patients were female (63%) with a mean age of 72 (67-78) years. Common comorbidities included type 2 diabetes mellitus (63%), hypertension (98%), dyslipidaemia (92%) and congestive cardiac failure (38%). Polypharmacy was prevalent, affecting 53% of the participants. Despite 96% of participants being adherent, all had at least one barrier to adherence, with the majority (65%) having more than one barrier. The main barriers were forgetfulness (59%), fear of side effects (39%), problems with taking the medications (26%) and believing medications are poisonous (22%). Although most participants accessed the pharmacy easily, only 83% reported consistent medication availability and 11% could not afford to collect their medication.
Polypharmacy is common in the population. Despite high adherence rates, barriers such as believing medications are poisonous remain significant. A good patient-doctor relationship improves adherence.Contribution: Understanding the barriers to adherence in older adults with polypharmacy and multimorbidity can assist practitioners improve patient care.
在老年人群体中，药物治疗的依从性是管理慢性病的一个挑战。本研究评估了在海伦·约瑟夫医院门诊部就诊的老年患者的药物依从率和影响药物依从性的因素。
这是一项对 130 名年龄在 65 岁及以上、至少患有两种慢性病的患者进行的前瞻性横断面研究。参与者接受了一项问卷调查，其中包括药物依从性评定量表和药物依从性障碍问卷，分别用于识别药物依从性和患者特有的药物依从性障碍。这些工具是可靠和有效的。
采用描述性统计和逻辑回归进行分析。大多数患者为女性（63%），平均年龄为 72（67-78）岁。常见的合并症包括 2 型糖尿病（63%）、高血压（98%）、血脂异常（92%）和充血性心力衰竭（38%）。同时使用多种药物很常见，影响了 53%的参与者。尽管 96%的参与者是依从的，但所有人都至少有一种药物依从性障碍，大多数（65%）有不止一种障碍。主要障碍包括健忘（59%）、害怕副作用（39%）、服药问题（26%）和认为药物有毒（22%）。尽管大多数参与者都能方便地到药房取药，但只有 83%的人报告说药物始终能按时供应，11%的人负担不起取药的费用。
该人群中同时使用多种药物很常见。尽管依从率较高，但仍存在一些重要的障碍，如认为药物有毒。良好的医患关系可以提高患者的依从性。
了解同时患有多种疾病的老年患者药物依从性的障碍因素可以帮助医生改善患者的治疗效果。
