Adherence to medicines in the older-aged with chronic conditions : does an intervention concerning adherence by an allied health professional help?


Autoria(s): Doggrell, Sheila
Data(s)

2010

Resumo

Adherence to medicines is a major determinant of the effectiveness of medicines. However, estimates of non-adherence in the older-aged with chronic conditions vary from 40 to 75%. The problems caused by non-adherence in the older-aged include residential care and hospital admissions, progression of the disease, and increased costs to society. The reasons for non-adherence in the older-aged include items related to the medicine (e.g. cost, number of medicines, adverse effects) and those related to person (e.g. cognition, vision, depression). It is also known that there are many ways adherence can be increased (e.g. use of blister packs, cues). It is assumed that interventions by allied health professions, including a discussion of adherence, will improve adherence to medicines in the older aged but the evidence for this has not been reviewed. There is some evidence that telephone counselling about adherence by a nurse or pharmacist does improve adherence, short- and long-term. However, face-to-face intervention counselling at the pharmacy, or during a home visit by a pharmacist, has shown variable results with some studies showing improved adherence and some not. Education programs during hospital stays have not been shown to improve adherence on discharge, but education programs for subjects with hypertension have been shown to improve adherence. In combination with an education program, both counselling and a medicine review program have been shown to improve adherence short-term in the older-aged. Thus, there are many unanswered questions about the most effective interventions to promote adherence. More studies are needed to determine the most appropriate interventions by allied health professions, and these need to consider the disease state, demographics, and socio-economic status of the older-aged subject, and the intensity and duration of intervention needed.

Formato

application/pdf

Identificador

http://eprints.qut.edu.au/38307/

Publicador

Adis International Ltd

Relação

http://eprints.qut.edu.au/38307/1/c38307.pdf

DOI:10.2165/11532870-000000000-00000

Doggrell, Sheila (2010) Adherence to medicines in the older-aged with chronic conditions : does an intervention concerning adherence by an allied health professional help? Drugs and Aging, 27(3), pp. 239-254.

Direitos

Copyright 2010 Adis Data Information BV

Fonte

Faculty of Science and Technology; Medical Sciences

Palavras-Chave #111502 Clinical Pharmacology and Therapeutics #Adherence to medicines #Chronic medical conditions #Older-aged
Tipo

Journal Article