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Shehnshah, M., Iqbal Arain, M., Ali Ghoto, M., Dayo, A., Shahnaz, S., & Anwar, R. (2021). Interventional Study on Adherence to Pharmacotherapy and Drug Pattern in Elderly Patients at Civil Hospital of Badin, Pakistan. Sudan Journal of Medical Sciences (SJMS), 16(3), 325–333. https://doi.org/10.18502/sjms.v16i3.9694
https://doi.org/10.18502/sjms.v16i3.9694
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authors
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Muhammad Shehnshah
Muhammad Shehnshah
Department of Pharmaceutics, Faculty of Pharmacy, University of Sindh, Jamshoro, Pakistan
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Mudassar Iqbal Arain
Mudassar Iqbal Arain
Department of Pharmacy Practice, Faculty of Pharmacy, University of Sindh, Jamshoro, Pakistan
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Muhammad Ali Ghoto
Muhammad Ali Ghoto
Department of Pharmacy Practice, Faculty of Pharmacy, University of Sindh, Jamshoro, Pakistan
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Abdullah Dayo
Abdullah Dayo
Department of Pharmaceutics, Faculty of Pharmacy, University of Sindh, Jamshoro, Pakistan
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Saira Shahnaz
Saira Shahnaz
Faculty of Pharmacy, Nazeer Hussain University, Karachi, Pakistan
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Ramesha Anwar
Ramesha Anwar
Department of Pharmacy Practice, Faculty of Pharmacy, University of Karachi, Karachi, Pakistan
Published Date
- Sep 30, 2021
Interventional Study on Adherence to Pharmacotherapy and Drug Pattern in Elderly Patients at Civil Hospital of Badin, Pakistan
Abstract
Background: To assess the contributing factors to adherence of pharmacotherapy and perception of elderly patients.
Methods: This prospective cross-sectional study was conducted in the outpatient clinic of Civil Hospital Badin, Pakistan from January to June 2019. A total of 300 samples were selected to analyze the results. A self-designed proforma (prescribing indicator form) was used for collecting data including patient demographics, diagnosis, and the current medications prescribed for each patient.
Results: Of the 300 selected participants, 221(73.7%) were male, while 79 (26.3%) were female. Majority of the subjects in the age group of 60–69 (52%) and 70–79 years (27%) followed by those aged >79 (21%). Antibiotics were prescribed to 17.2% and vitamins to 14.7%. Patients’ responses related to nonadherence factor were 92.7% for the cost, 32.7% for the long treatment duration, and 24% for the lack of knowledge. Out of the total patients, 28% were forgetful, 26.7% complained about complex therapy, 26.3% blamed financial problems, 19.7% patients had side effects, and 14.3% were negligent in taking the medication.
Conclusion: Patient conformity can be enhanced by dropping polypharmacy and simplifying complex management, use of extended formulations, rate of medications, and by creating awareness among elderly patients.
Keywords: elderly, polypharmacy, pharmacotherapy, adherence
References
[1] Kocurek, B. (2009). Promoting medication adherence in older adults and the rest of us. Diabetes Spectrum, vol. 22, no. 2, pp. 80–84.
[2] Saleem, F., Hassali, M., Shafie, A., et al. (2012). Drug attitude and adherence: a qualitative insight of patients with hypertension. Journal of Young Pharmacists, vol. 4, no. 2, pp. 101–107.
[3] Ramanath, K. V., Balaji, D. B. S. S., Nagakishore, C. H., et al. (2012). A study on impact of clinical pharmacist interventions on medication adherence and quality of life in rural hypertensive patients. Journal of Young Pharmacists, vol. 4, no. 2, pp. 95–100.
[4] Schumaker, S. A. and Naughton, M. J. (1995). The international assessment of healthrelated quality of life: a theorical perspective. In: S. A. Schumaker and R. A. Berzon (Eds.), Quality of Life: Theory, Translation, Measurement and Analysis (pp. 3–10). Oxford: Rapid Communications.
[5] Zamora-SaÂnchez, J. J., PeÂrez-Tortajada, G., Mendoza-GarcõÂa de Paredes, M. D., et al. (2012). Quality of life perceived by complex patients in a case management program in primary health care. Enfermería Clínica, vol. 22, no. 5, pp. 239–246.
[6] BadõÂa, X., Salamero, M., Alonso, J., et al. (Eds.). (1999). Health measure. In Measurement Scales Guide in Spanish (2nd ed.). Barcelona: Edimac.
[7] Tudela, L. L. (2009). Health-related quality of life. Aten Primaria, vol. 41, no. 7, pp. 411–416.
[8] World Health Organization. (2013). Adherence to Long-term Therapies: Evidence for Action. WHO.
[9] Horne, R. and Weinman, J. (1999). Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. Journal of Psychosomatic Research, vol. 47, no. 6, pp. 555–567.
[10] Ferrer, A., Formiga, F., Almeda, J., et al. (2010). Health-related quality of life in nonagenarians: gender, functional status and nutritional risk as associated factors. Medicina Clínica, vol. 134, no. 7, pp. 303–306.
[11] De Rivas, B., Permanyer-Miralda, G., Brotons, C., et al. (2008). Health related quality of life in unselected outpatients with heart failure across Spain in two different health care levels. Magnitude and determinants of impairment: the INCA study. Quality of Life Research, vol. 17, no. 10, pp. 1229–1238.
[12] Schuz, B., Marx, C., Wurm, S., et al. (2011). Medication beliefs predict medication adherence in older adults with multiple illnesses. Journal of Psychosomatic Research, vol. 70, no. 2, pp. 179–187.
[13] Sirey, J. A., Weinberger, M. I., Greenfield, A., et al. (2013). Medication beliefs and selfreported adherence among community-dwelling older adults. Clinical Therapeutics, vol. 35, no. 2, pp. 153–160.
[14] Rajpura, J. R. and Nayak, R. (2014). Role of illness perceptions and medication beliefs on medication compliance of elderly hypertensive cohorts. Journal of Pharmacy Practice, vol. 27, no. 1, pp. 19–24.
[15] Krauskopf, K., Federman, A. D., Kale, M. S., et al. (2015). Chronic obstructive pulmonary disease illness and medication beliefs are associated with medication adherence. COPD: Journal of Chronic Obstructive Pulmonary Disease, vol. 12, no. 2, pp. 151–164.
[16] Kalichman, S. C., Eaton, L., Kalichman, M. O., et al. (2016). Race-based medical mistrust, medication beliefs and HIV treatment adherence: test of a mediation model in people living with HIV/AIDS. Journal of Behavioral Medicine, vol. 39, no. 6, pp. 1056–1064.
[17] Rajpura, J. and Nayak, R. (2014). Medication adherence in a sample of elderly suffering from hypertension: evaluating the influence of illness perceptions, treatment beliefs, and illness burden. Journal of Managed Care Pharmacy, vol. 20, no. 1, pp. 58–65.
[18] Azpiazu, M., Cruz, A., Villagrasa, J. R., et al. (2003). Quality of life in no institutionalized persons older than 65 years in two health care districts in Madrid. Atención Primaria, vol. 31, no. 5, pp. 285–294.
[19] Van der Weele, G. M., Gussekloo, J., De Waal, M. W., et al. (2008). Co-occurrence of depression and anxiety in elderly subjects aged 90 years and its relationship with functional status, quality of life and mortality. International Journal of Geriatric Psychiatry, vol. 24, no. 6, p. 595–601.
[20] Tjia, J., Givens, J. L., Karlawish, J. H., et al. (2008). Beneath the surface: discovering the unvoiced concerns of older adults with type 2 diabetes mellitus. Health Education Research, vol. 23, no. 1, pp. 40–52.
[21] Vermeire, E., Hearnshaw, H., Van Royen, P., et al. (2001). Patient adherence to treatment: three decades of research. A comprehensive review. Journal of Clinical Pharmacy and Therapeutics, vol. 26, pp. 331–342.
[22] Lam, W. Y. and Fresco, P. (2015). Medication adherence measures: an overview. BioMed Research International, vol. 2015, p. 217047.
[23] Brown, M. T. and Bussell, J. K. (2011). Medication adherence: WHO cares? Mayo Clinic Proceedings, vol. 86, no. 4, pp. 304–314.
[24] Johnson, M. J., Williams, M., and Marshall, E. S. (1999). Adherent and nonadherent medication-taking in elderly hypertensive patients. Clinical Nursing Research, vol. 8, no. 4, pp. 318–335.
[25] Nikolaus, T., Kruse, W., Bach, M., et al. (1996). Elderly patients’ problems with medication. European Journal of Clinical Pharmacology, vol. 49, no. 4, pp. 255– 259.
[26] Navaratnam, P., Jayawant, S. S., Pedersen, C. A., et al. (2008). Asthma pharmacotherapy prescribing in the ambulatory population of the United States: evidence of nonadherence to national guidelines and implications for elderly people. Journal of the American Geriatrics Society, vol. 56, no. 7, pp. 1312–1317.
[27] Roy, N. T., Sajith, M., and Bansode, M. P. (2017). Assessment of Factors Associated with Low Adherence to Pharmacotherapy in Elderly Patients. Journal of Young Pharmacists, vol. 9, no. 2, pp. 272–276.
[28] Fernandez-Arias, M., Acuna-Villaorduna, A., Miranda, J. J., et al. (2014). Adherence to pharmacotherapy and medication-related beliefs in patients with hypertension in Lima, Peru. PloS ONE, vol. 9, no. 12, p. e112875.
[29] Payne, K. A. and Esmonde-White, S. (2000). Observational studies of antihypertensive medication use and compliance: is drug choice a factor in treatment adherence? Current Hypertension Reports, vol. 2, no. 6, pp. 515–524.
[2] Saleem, F., Hassali, M., Shafie, A., et al. (2012). Drug attitude and adherence: a qualitative insight of patients with hypertension. Journal of Young Pharmacists, vol. 4, no. 2, pp. 101–107.
[3] Ramanath, K. V., Balaji, D. B. S. S., Nagakishore, C. H., et al. (2012). A study on impact of clinical pharmacist interventions on medication adherence and quality of life in rural hypertensive patients. Journal of Young Pharmacists, vol. 4, no. 2, pp. 95–100.
[4] Schumaker, S. A. and Naughton, M. J. (1995). The international assessment of healthrelated quality of life: a theorical perspective. In: S. A. Schumaker and R. A. Berzon (Eds.), Quality of Life: Theory, Translation, Measurement and Analysis (pp. 3–10). Oxford: Rapid Communications.
[5] Zamora-SaÂnchez, J. J., PeÂrez-Tortajada, G., Mendoza-GarcõÂa de Paredes, M. D., et al. (2012). Quality of life perceived by complex patients in a case management program in primary health care. Enfermería Clínica, vol. 22, no. 5, pp. 239–246.
[6] BadõÂa, X., Salamero, M., Alonso, J., et al. (Eds.). (1999). Health measure. In Measurement Scales Guide in Spanish (2nd ed.). Barcelona: Edimac.
[7] Tudela, L. L. (2009). Health-related quality of life. Aten Primaria, vol. 41, no. 7, pp. 411–416.
[8] World Health Organization. (2013). Adherence to Long-term Therapies: Evidence for Action. WHO.
[9] Horne, R. and Weinman, J. (1999). Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. Journal of Psychosomatic Research, vol. 47, no. 6, pp. 555–567.
[10] Ferrer, A., Formiga, F., Almeda, J., et al. (2010). Health-related quality of life in nonagenarians: gender, functional status and nutritional risk as associated factors. Medicina Clínica, vol. 134, no. 7, pp. 303–306.
[11] De Rivas, B., Permanyer-Miralda, G., Brotons, C., et al. (2008). Health related quality of life in unselected outpatients with heart failure across Spain in two different health care levels. Magnitude and determinants of impairment: the INCA study. Quality of Life Research, vol. 17, no. 10, pp. 1229–1238.
[12] Schuz, B., Marx, C., Wurm, S., et al. (2011). Medication beliefs predict medication adherence in older adults with multiple illnesses. Journal of Psychosomatic Research, vol. 70, no. 2, pp. 179–187.
[13] Sirey, J. A., Weinberger, M. I., Greenfield, A., et al. (2013). Medication beliefs and selfreported adherence among community-dwelling older adults. Clinical Therapeutics, vol. 35, no. 2, pp. 153–160.
[14] Rajpura, J. R. and Nayak, R. (2014). Role of illness perceptions and medication beliefs on medication compliance of elderly hypertensive cohorts. Journal of Pharmacy Practice, vol. 27, no. 1, pp. 19–24.
[15] Krauskopf, K., Federman, A. D., Kale, M. S., et al. (2015). Chronic obstructive pulmonary disease illness and medication beliefs are associated with medication adherence. COPD: Journal of Chronic Obstructive Pulmonary Disease, vol. 12, no. 2, pp. 151–164.
[16] Kalichman, S. C., Eaton, L., Kalichman, M. O., et al. (2016). Race-based medical mistrust, medication beliefs and HIV treatment adherence: test of a mediation model in people living with HIV/AIDS. Journal of Behavioral Medicine, vol. 39, no. 6, pp. 1056–1064.
[17] Rajpura, J. and Nayak, R. (2014). Medication adherence in a sample of elderly suffering from hypertension: evaluating the influence of illness perceptions, treatment beliefs, and illness burden. Journal of Managed Care Pharmacy, vol. 20, no. 1, pp. 58–65.
[18] Azpiazu, M., Cruz, A., Villagrasa, J. R., et al. (2003). Quality of life in no institutionalized persons older than 65 years in two health care districts in Madrid. Atención Primaria, vol. 31, no. 5, pp. 285–294.
[19] Van der Weele, G. M., Gussekloo, J., De Waal, M. W., et al. (2008). Co-occurrence of depression and anxiety in elderly subjects aged 90 years and its relationship with functional status, quality of life and mortality. International Journal of Geriatric Psychiatry, vol. 24, no. 6, p. 595–601.
[20] Tjia, J., Givens, J. L., Karlawish, J. H., et al. (2008). Beneath the surface: discovering the unvoiced concerns of older adults with type 2 diabetes mellitus. Health Education Research, vol. 23, no. 1, pp. 40–52.
[21] Vermeire, E., Hearnshaw, H., Van Royen, P., et al. (2001). Patient adherence to treatment: three decades of research. A comprehensive review. Journal of Clinical Pharmacy and Therapeutics, vol. 26, pp. 331–342.
[22] Lam, W. Y. and Fresco, P. (2015). Medication adherence measures: an overview. BioMed Research International, vol. 2015, p. 217047.
[23] Brown, M. T. and Bussell, J. K. (2011). Medication adherence: WHO cares? Mayo Clinic Proceedings, vol. 86, no. 4, pp. 304–314.
[24] Johnson, M. J., Williams, M., and Marshall, E. S. (1999). Adherent and nonadherent medication-taking in elderly hypertensive patients. Clinical Nursing Research, vol. 8, no. 4, pp. 318–335.
[25] Nikolaus, T., Kruse, W., Bach, M., et al. (1996). Elderly patients’ problems with medication. European Journal of Clinical Pharmacology, vol. 49, no. 4, pp. 255– 259.
[26] Navaratnam, P., Jayawant, S. S., Pedersen, C. A., et al. (2008). Asthma pharmacotherapy prescribing in the ambulatory population of the United States: evidence of nonadherence to national guidelines and implications for elderly people. Journal of the American Geriatrics Society, vol. 56, no. 7, pp. 1312–1317.
[27] Roy, N. T., Sajith, M., and Bansode, M. P. (2017). Assessment of Factors Associated with Low Adherence to Pharmacotherapy in Elderly Patients. Journal of Young Pharmacists, vol. 9, no. 2, pp. 272–276.
[28] Fernandez-Arias, M., Acuna-Villaorduna, A., Miranda, J. J., et al. (2014). Adherence to pharmacotherapy and medication-related beliefs in patients with hypertension in Lima, Peru. PloS ONE, vol. 9, no. 12, p. e112875.
[29] Payne, K. A. and Esmonde-White, S. (2000). Observational studies of antihypertensive medication use and compliance: is drug choice a factor in treatment adherence? Current Hypertension Reports, vol. 2, no. 6, pp. 515–524.