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

Javier González-Bueno, Daniel Sevilla-Sánchez, Emma Puigoriol-Juvanteny, Núria Molist-Brunet, Carles Codina-Jané and Joan Espaulella-Panicot
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Javier González-Bueno: Pharmacy Department, Consorci Hospitalari de Vic, 08500 Barcelona, Spain
Daniel Sevilla-Sánchez: Central Catalonia Chronicity Research Group (C3RG), University of Vic—Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain
Emma Puigoriol-Juvanteny: Epidemiology Unit, Consorci Hospitalari de Vic, 08500 Barcelona, Spain
Núria Molist-Brunet: Central Catalonia Chronicity Research Group (C3RG), University of Vic—Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain
Carles Codina-Jané: Pharmacy Department, Consorci Hospitalari de Vic, 08500 Barcelona, Spain
Joan Espaulella-Panicot: Central Catalonia Chronicity Research Group (C3RG), University of Vic—Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain

IJERPH, 2021, vol. 18, issue 18, 1-14

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.

Keywords: multimorbidity; elderly; polypharmacy; inappropriate prescribing; medication adherence (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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