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Cited by 334Medication Adherence and CompliancePharmaceutical Practices and Patient OutcomesPharmacy and Medical Practices

Drug therapy in the elderly: what doctors believe and patients actually do

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Barat, I., Andreasen, F., Damsgaard, E. M. S.·2001·British Journal of Clinical Pharmacology
DOI 10.1046/j.0306-5251.2001.01401.xPMC PMC2014493
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Abstract

Aims To examine the medication adherence among old persons living in their own homes, to assess their knowledge of their medication, and to indicate target areas for intervention. Methods A cross‐sectional study of data collected from randomly selected samples of 348 persons, aged 75 years recruited from a population‐based register in the municipality of Aarhus, Denmark. Information on all drugs was collected from the subjects during a home visit, and their drug storage was examined. Information was collected from the general practitioners (GP). The measures of adherence were scores of agreements between the GPs' lists and the subjects' actual drug consumption. Results We found disagreement between the drug information collected from the study population and from the GPs: concerning drugs in 22% of the study‐population, concerning doses in 71%, and concerning regimens prescribed by the GP in 66%. Twenty‐four percent stated that they did not always follow prescriptions. Most of the deviations from prescriptions were toward lower doses and less frequent drug intake. The drugs most often involved in deviations were hypnotics, analgesics, bronchodilators and diuretics. Sixty percent of the participants knew the purpose of medication, and 21% knew the consequences of omission of the drugs. Less than 6% of the subjects knew about the toxic risks, side‐effects, or potential drug interactions. The participants' knowledge of the drugs was positively associated with their adherence. We found a correlation between an increased number of prescribed frequency of drug intake per day and deviation from the regimen (r = 0.25, P = 0.01). There was a positive association between nonadherence and the use of three or more drugs (odds ratio (OR) 2.5; 95% confidence interval (CI) 1.5,4.1), prescriptions from more than one doctor (OR 2.5; 95% CI 1.3,4.8), and probability of dementia (OR 9.0; 95% CI 1.1,72.5). Moreover compliance aids facilitated adherence (OR 4.4; 95% CI 1.6,12.3). Persons living alone were more prone to medication errors (OR 2.0; 95% CI 1.1,3.5). Conclusions A differentiated evaluation of adherence by considering the drug, the dose, and the regimen separately produced quantifiable data concerning the subjects' medication habits. Non‐adherence ranged from 20 to 70% depending on the measuring method. The participants' knowledge of the treatment was poor. Our results suggest that better information on medication and the use of compliance aids may prevent nonadherence. Special attention should be paid to persons receiving three or more drugs, living alone, receiving drugs from other doctors, and to persons with predementia symptoms, as they are at higher risk of nonadherence.

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  • Implementation fidelity of prescribed drug interventions for elderly people in the community can be low because these patients deliberately fail to comply with their prescribed regimens.

    “it has been found that implementation fidelity of prescribed drug interventions for elderly people in the community can be low because these patients deliberately fail to comply with their prescribed regimens [31-33].”

    From A conceptual framework for implementation fidelity (2007) · cites this paper as [32]

  • Self-report is the most common means of evaluating the responsiveness of all participants to an intervention.

    “Self-report is the most common means of evaluating the responsiveness of all participants to an intervention [30-34,37].”

    From A conceptual framework for implementation fidelity (2007) · cites this paper as [32]

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Authors
Barat, I., Andreasen, F., & Damsgaard, E. M. S.
Affiliations
  • Aarhus University (DK)
  • Marselisborgcentret (DK)
Corresponding author
Barat, I.
ORCID
Damsgaard, E. M. S.
Venue
British Journal of Clinical Pharmacology
Publisher
Wiley
Published
2001-06
Volume
51
Issue
6
Pages
615-622
ISSN
  • 0306-5251 (ISSN-L)
  • 1365-2125
DOI
10.1046/j.0306-5251.2001.01401.x
PMC
PMC2014493
OpenAlex
W2064390542
Cited by
334
References
26
Citations by year
2026: 1 · 2025: 1 · 2024: 3 · 2023: 11 · 2022: 13 · 2021: 8 · 2020: 10 · 2019: 12 · 2018: 14 · 2017: 15 · 2016: 18 · 2015: 18 · 2014: 21 · 2013: 18 · 2012: 26
FWCI
9.81
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 237 d)
Locations
  • British Journal of Clinical Pharmacology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
Keywords
medication adherence, older adults, polypharmacy, medication knowledge, medication errors, dementia, hypnotics, analgesics, drug interactions, adverse effects, drug storage, general practitioners, living alone, Denmark
MeSH terms
Aged, Cross-Sectional Studies, Denmark, Female, Humans, Male, Patient Compliance, Patient Education as Topic, Drug Prescriptions, Research Design, Statistics as Topic, Treatment Refusal

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