Prevalence and predictors of medication non‐adherence among older community‐dwelling people with chronic disease in Singapore
- 1 June 2021
- journal article
- research article
- Published by Wiley in Journal of Advanced Nursing
- Vol. 77 (10), 4069-4080
- https://doi.org/10.1111/jan.14913
Abstract
Aims To determine the prevalence and predictors of medication non-adherence among older community-dwelling people with at least one chronic disease in Singapore. Design A single-centre cross-sectional study. Methods The study was conducted in the largest tertiary public hospital in Singapore between May 2019 and December 2019. The community nurses of the hospital recruited a total of 400 community-dwelling older people aged ≥60 years old, who were diagnosed with at least one chronic disease and prescribed with at least one long-term medication. Medication non-adherence was assessed using the self-report 5-item Medication Adherence Report Scale, operationalized as a score of n = 240) of our participants were non-adherent to their medication regime. Older people who smoked (OR 2.89, 95% CI 1.14–7.33), perceived their medication regime as being complicated (OR 2.54, 95% CI 1.26–5.13), felt dissatisfied with their regime (OR 2.50, 95% CI 1.17–5.31), did not know the purpose of all their medications (OR 2.56, 95% CI 1.42–4.63) and experienced side effects (OR 3.32, 95% CI 1.14–9.67) were found to be predictive of medication non-adherence. Conclusion Medication adherence was found to be poor in community-dwelling older people in Singapore. The predictors identified in this study can help guide healthcare professionals in identifying older people who are at risk of medication non-adherence and inform the development of interventions to improve adherence. Impact Medication non-adherence, especially in the older population with chronic diseases, constitutes a serious problem as it undermines the efforts to reduce morbidity and mortality associated with the underlying chronic diseases. To improve adherence, our findings propose the importance of assessing the older person's treatment satisfaction, which includes examining the aspects of side effects, effectiveness and convenience. Additionally, we highlight the need to address the older person's medication knowledge deficit.Keywords
This publication has 33 references indexed in Scilit:
- A new taxonomy for describing and defining adherence to medicationsBritish Journal of Clinical Pharmacology, 2012
- Psychometric Properties of Three Medication Adherence Scales in Patients With Rheumatoid ArthritisJournal of Nursing Measurement, 2012
- The impact of medication regimen factors on adherence to chronic treatment: a review of literatureJournal of Behavioral Medicine, 2008
- Continuity and Adherence to Long-Term Drug Treatment by Geriatric Patients after Hospital DischargeDrugs & Aging, 2008
- Complementary and alternative medicine use in multiracial SingaporeComplementary Therapies in Medicine, 2005
- Drug related medical emergencies in the elderly: role of adverse drug reactions and non-compliancePostgraduate Medical Journal, 2001
- Cognitive Screening in Mild Traumatic Brain Injuries: Analysis of the Neurobehavioral Cognitive Status Examination When Utilized during Initial Trauma HospitalizationJournal of Neurotrauma, 1997
- Inter‐rater reliability of the original and modified Barthel Index, and a comparison with the Functional Independence MeasureAustralian Occupational Therapy Journal, 1997
- Improving the sensitivity of the Barthel Index for stroke rehabilitationJournal of Clinical Epidemiology, 1989
- The Barthel ADL Index: A reliability studyInternational Disability Studies, 1988