Introduction
Aging is an inevitable part of life. With aging comes the package of health issues, which can be limiting and interfere with the quality of life. Youth is colorful and vibrant with energy, while old age can be graying and struggling for energy to sustain life. However, this can be managed (to an extent, of course!) by adhering to the medicines one has been prescribed. This can keep the wails and ails at bay and improve one’s view of life as well. This article deals with the importance of medication adherence in the elderly.
What Is Medication Adherence?
The term ‘medication adherence’ refers to whether the patient takes the right medicines prescribed to them at the right time, at the right frequency, or at the right doses. In addition, it can also mean that they continue to take the medicine as prescribed. It measures the extent to which the patient’s behavior adheres to or follows the instructions provided by the healthcare professional.
What Are the Effects of Not Adhering to a Prescribed Medicine?
Not adhering to the prescribed medication can cause a negative impact and can reduce the effect of the prescribed medication. It increases the adverse outcomes and increases the cost of treatment. Moreover, in some medicines (like in the case of antibiotics), improper adherence can cause the pathogen to become resistant to the drug. As a result, it would not yield the desired results the next time. This causes medication adherence to be a topic of utmost importance to healthcare professionals and the healthcare system as a whole.
Who Are Considered Elderly?
A person older than sixty or sixty-five years of age is considered elderly. The World Health Organisation (WHO) predicts that the number of people over sixty years of age will be doubled by 2050, while the number of people over eighty will be around four million. This can be a result of advanced medical care and the efficiency of technology in healthcare systems. This includes better treatment options, increased focus on preventive therapies, and the use of pharmacotherapy (the process of treating health conditions using one or more drugs to improve ongoing symptoms, underlying conditions, or in the prevention of diseases. Studies show that people tend to use medicines more than before and also try to follow healthcare providers' instructions.
Why Is Medication Adherence Important in the Elderly?
As a person becomes old, there could be more than one condition that requires medication consistently. Hence, the risk of not adhering to the medicines is higher in the elderly than in the young population. Not following the medication as prescribed can lead to reduced therapeutic benefits, increased frequency of hospital visits, or physician visits because of ill health. This can increase the expenditure for healthcare and over-treatment in some cases, as the medicine would have become resistant to the body.
For instance, if the medicines are not taken on time, the blood sugar levels of diabetic patients might not be at the therapeutic range (normal levels). When it falls below the therapeutic range, the medicine might not be able to reduce the blood glucose levels. As a result, the blood glucose levels spike up. The blood sugar levels might be spiked during their doctor visits. As a result, their doses might be increased in order to manage the elevated blood sugar levels (if the doctor does not check regarding the patient’s medicine compliance). This can increase the episodes of hypoglycemic (blood sugar levels dropping below normal) episodes. This can be harmful to the patient if not managed appropriately. In addition, the disease may progress in the long run and might not be well-controlled.
What Are the Reasons for Poor Medicine Adherence in the Elderly?
According to the WHO, the factors affecting medicine adherence are divided into patient factors, medication factors, healthcare provider factors, healthcare system factors, and socio-economic factors.
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Patient Factors: Adherence to medicine can depend on the individual’s willingness to and ability. It can also depend on their mental state, physical health, demographics, past medical history, behavior or habits, knowledge, and beliefs. Mental state can include conditions like depression, anxiety, impaired cognitive functions, etc. Conditions revolving around their physical health can include their BMI (body mass index), ability to hear, physical functioning, etc. Demographics like gender, marital status, culture, low education levels, ethnicity, etc can also influence the patient’s adherence. Behavior or attitude can include non-adherence to follow-up visits, use of alternative medicines, habits like alcoholism, relationship issues, etc. The lack of knowledge of the medicines or misconceptions about them can also cause them not to follow guidelines appropriately.
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Medication Factors: Factors on medication, like formulation and packaging, drug regimen and drug handling, presence of adverse drug reactions, drug interactions, poor labeling instruction, and the lack of consequences for missing a dose, can impair medicine adherence. A simpler dosing schedule, like every morning dose or twice daily dosing, can help the elderly remember the schedule better than one to be taken on alternate days. As a result, it increases patient compliance and yields better results.
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Healthcare Provider Factors: With the advancement of technology, medication adherence can be improved by using reminders on their mobiles or installing applications that can help the patient track their progress. Trust in the healthcare provider is another important factor that can influence medication adherence. Poor communication, dissatisfied doctor visits, etc., could be other reasons for non-compliance.
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Healthcare System Factors: The need for more patient education, lack of follow-up, unavailability of medication schedules given, short prescription duration, and lack of community nursing services can reduce medication adherence in patients. For example, when a shorter prescription is given, there is a chance that the elderly patient might not comply with the instructions, as they might think more frequent visits to the pharmacy are required. Hence, convincing the patient why a short-duration medicine was given can help them to follow the schedule better.
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Socio-economic Factor: The lack of proper caregivers and the larger caregiver burden increase the risk of non-compliance.
How Can Poor Medicine Adherence in the Elderly Be Improved?
Poor medication adherence can be improved by finding out the reason behind it. Patient education can be beneficial if it is due to the lack of awareness. If it is due to the lack of trust in the healthcare provider, steps can be taken to improve it. An easier-to-remember schedule can be given, along with daily reminders for better compliance. Understanding why the patient fails to adhere to the prescription can solve the problem to an extent.
Conclusion
Medicine adherence is important in improving health, especially in the elderly. Understanding why they fail to adhere to the prescription and taking appropriate steps to solve it can yield better results. This, in turn, reduces healthcare expenses and drug resistance. Regular reminders can also help the patient to remember to take their medicines on time. Trust between the healthcare provider and the patient is paramount when compliance with medicines is considered.
