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GERIATRICS

Prescription Medications: Beliefs, Experiences, Behavior, and Adherence of Sheltered Housing Residents

Prescribing Research Fellow, School of Pharmacy, The Robert Gordon University, School-hill, Aberdeen, Scotland

Kim Munro, BSc MSc MRPharmS

Lecturer, School of Pharmacy, The Robert Gordon University

Dorothy J McCaig, BSc PhD

Senior Lecturer, School of Pharmacy, The Robert Gordon University

Derek C Stewart, BSc MSc PhD MRPharmS

Senior Lecturer, School of Pharmacy, The Robert Gordon University

Reprints: Dr. George, School of Pharmacy, The Robert Gordon University, Aberdeen, Scotland AB10 1FR, UK, fax 44-1224-262 555, j.george{at}rgu.ac.uk

BACKGROUND: Data on medication utilization among residents of sheltered housing complexes (SHCs) are limited.

OBJECTIVE: To evaluate the extent of nonadherence to prescribed medications among residents of SHCs and identify factors associated with nonadherence.

METHODS: A 58 item, pre-piloted questionnaire with validated items for patient self-assessment of medication risk; adherence; disability; health beliefs, experiences, and behavior; and general items on demographics, health, and medication use was mailed to 1137 SHC residents in Aberdeen, Scotland. Predictors of nonadherence (Morisky score >0) were identified using logistic regression.

RESULTS: Of the 695 (61.1%) respondents, 645 (mean ± SD age, 78.2 ± 7.8 y) reported using prescribed drugs. Nonadherence was reported by 176 of 627 (28.1%) residents. The predictors of nonadherence were: disagreeing with the statement, "I ensure I have enough medicines so that I don't run out" (OR 0.48; 95% CI 0.30 to 0.77), agreeing with the statements, "I make changes in the recommended management to suit my lifestyle" (OR 1.32; 95% CI 1.09 to 1.60) and "I get confused about my medicines" (OR 1.39; 95% CI 1.10 to 1.77), younger age (OR 0.96; 95% CI 0.94 to 0.99), not getting help from someone to use the medications correctly (OR 2.20; 95% CI 1.21 to 3.99), and agreeing with the statement, "I am concerned about the side effects from my medicines" (OR 1.31; 95% CI 1.05 to 1.63).

CONCLUSIONS: Over one-quarter of SHC residents were found to be nonadherent to prescribed drugs. Risk factors for nonadherence include younger age, confusion about drugs, lack of support for drug supply and administration, interference of treatment recommendations with lifestyle, and a perceived view of risks outweighing benefits in using recommended drug therapy.

Key Words: adherence, elderly, health beliefs, medication risk, sheltered housing

Published Online, October 31, 2006. www.theannals.com, DOI 10.1345/aph.1H355

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