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Factors Associated with Medication Non-Adherence among Patients with Multimorbidity and Polypharmacy Admitted to an Intermediate Care Center

Author

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  • Javier González-Bueno

    (Pharmacy Department, Consorci Hospitalari de Vic, 08500 Barcelona, Spain
    Central Catalonia Chronicity Research Group (C3RG), University of Vic—Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain)

  • Daniel Sevilla-Sánchez

    (Central Catalonia Chronicity Research Group (C3RG), University of Vic—Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain
    Pharmacy Department, Parc Sanitari Pere Virgili, 08023 Barcelona, Spain)

  • Emma Puigoriol-Juvanteny

    (Epidemiology Unit, Consorci Hospitalari de Vic, 08500 Barcelona, Spain
    Tissue Repair and Regeneration Laboratory (TR2Lab) Group, Faculty of Sciences and Technology & Faculty of Medicine, University of Vic—Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain)

  • Núria Molist-Brunet

    (Central Catalonia Chronicity Research Group (C3RG), University of Vic—Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain
    Department of Geriatrics, Consorci Hospitalari de Vic & Fundació Hospital de la Santa Creu de Vic, 08500 Barcelona, Spain)

  • Carles Codina-Jané

    (Pharmacy Department, Consorci Hospitalari de Vic, 08500 Barcelona, Spain
    Central Catalonia Chronicity Research Group (C3RG), University of Vic—Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain)

  • Joan Espaulella-Panicot

    (Central Catalonia Chronicity Research Group (C3RG), University of Vic—Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain
    Department of Geriatrics, Consorci Hospitalari de Vic & Fundació Hospital de la Santa Creu de Vic, 08500 Barcelona, Spain)

Abstract

Identifying determinants of medication non-adherence in patients with multimorbidity would provide a step forward in developing patient-centered strategies to optimize their care. Medication appropriateness has been proposed to play a major role in medication non-adherence, reinforcing the importance of interdisciplinary medication review. This study examines factors associated with medication non-adherence among older patients with multimorbidity and polypharmacy. A cross-sectional study of non-institutionalized patients aged ≥65 years with ≥2 chronic conditions and ≥5 long-term medications admitted to an intermediate care center was performed. Ninety-three patients were included (mean age 83.0 ± 6.1 years). The prevalence of non-adherence based on patients’ multiple discretized proportion of days covered was 79.6% ( n = 74). According to multivariable analyses, individuals with a suboptimal self-report adherence (by using the Spanish-version Adherence to Refills and Medications Scale) were more likely to be non-adherent to medications (OR = 8.99, 95% CI 2.80–28.84, p < 0.001). Having ≥3 potentially inappropriate prescribing (OR = 3.90, 95% CI 0.95–15.99, p = 0.059) was barely below the level of significance. These two factors seem to capture most of the non-adherence determinants identified in bivariate analyses, including medication burden, medication appropriateness and patients’ experiences related to medication management. Thus, the relationship between patients’ self-reported adherence and medication appropriateness provides a basis to implement targeted strategies to improve effective prescribing in patients with multimorbidity.

Suggested Citation

  • Javier González-Bueno & Daniel Sevilla-Sánchez & Emma Puigoriol-Juvanteny & Núria Molist-Brunet & Carles Codina-Jané & Joan Espaulella-Panicot, 2021. "Factors Associated with Medication Non-Adherence among Patients with Multimorbidity and Polypharmacy Admitted to an Intermediate Care Center," IJERPH, MDPI, vol. 18(18), pages 1-14, September.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:18:p:9606-:d:633932
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    References listed on IDEAS

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    1. Virtudes Pérez-Jover & José J. Mira & Concepción Carratala-Munuera & Vicente F. Gil-Guillen & Josep Basora & Adriana López-Pineda & Domingo Orozco-Beltrán, 2018. "Inappropriate Use of Medication by Elderly, Polymedicated, or Multipathological Patients with Chronic Diseases," IJERPH, MDPI, vol. 15(2), pages 1-14, February.
    2. Palmer, Katie & Marengoni, Alessandra & Forjaz, Maria João & Jureviciene, Elena & Laatikainen, Tiina & Mammarella, Federica & Muth, Christiane & Navickas, Rokas & Prados-Torres, Alexandra & Rijken, Mi, 2018. "Multimorbidity care model: Recommendations from the consensus meeting of the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS)," Health Policy, Elsevier, vol. 122(1), pages 4-11.
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