Do Geriatric Outpatients Adhere to Medication Changes Advised After Assessment? An Exploratory Pilot Study

Linda   R.   Tulner; Suzanne   V.   Frankfort; Floor      Wesselius; Jos   P.C.M.   van Campen; Cornelis   H.W.   Koks; Jos   H.   Beijnen

doi:10.2174/157488409788184990

Abstract

Background: The most frequent intervention after Comprehensive Geriatric Assessment (CGA) is adjustment of medications. Adherence to recommendations is often incomplete. Patients at high risk of non-adherence should be identified. Objective: To explore if changes in drug-use after CGA are carried out by the patient. To identify factors influencing nonadherence. Methods: Co-morbidity and medication use were recorded. Patients, and when cognitively impaired, a caregiver, were questioned about advised changes. Drug-use before and after CGA was assessed. Patients were asked whether they would discontinue their drugs either with or without consulting their physician. Univariate logistic regression analysis to identify factors influencing non-adherence, was performed with SPSS. Results: Forty patients were included. Of the changes in medication advised, 90 % were reported to be carried out. 65 % of the patients were compliant. Only the presence of a caregiver was associated with reported complete adherence to drug therapy. Most patients cant describe for how long they will have to continue taking the drugs that are prescribed to them. Conclusion: Most geriatric patients carry out changes in medication made after CGA. Supervision by caregivers may explain a high rate of reported adherence despite the presence of polypharmacy and cognitive decline. Practice Implications: In the absence of caregivers special attention should be paid to adherence to medication changes. Information about intended duration of drug therapy should be improved.

Keywords: Geriatric, adherence, compliance, medication, caretaker, comprehensive geriatric assessment

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