Adherence to medicines in older adults (Do older people take their medicines?)

Overview

Topic status: We're looking for students to study this topic.

The effectiveness of treatment with a medicine depends on the efficacy of the medicine prescribed and the adherence to the medicine regimen. Although, it is widely recognized that medicines don't work in patients who don't take them, relatively little attention is paid to adherence to medicines. Ratified estimates of non-adherence in the older adults vary from 40 to 75% and non-adherence is more common in those taking 3 or more medicines. Even with one medicine, non-adherence increases with increased dosing [1]. Non-adherence in older people is a common cause for hospital admissions [2]. Non-adherence may also result in progression of the disease. For example, in an Aboriginal community (Tiwi) in late 1995, a treatment program for renal disease and hypertension resulted in reduced blood pressure, the stabilisation of renal function, and a decrease in renal and non-renal deaths [3]. Subsequently, when the intensity of the program declined, the adherence to medicines fell and this resulted in increased blood pressure, renal function deterioration, and a marked increase in the death rate [3]. In general, improved adherence to medicines will enhance the quality of health systems and outcomes by reducing hospital and residential care admissions, the mortality and morbidity associated with the progression of disease, and the costs of these to the community. As a first step, we hope to define where the problem is the greatest - is it with the older adult living alone? Or is it within Aboriginal communities? Subsequently, we intend to undertake an intervention trial to improve adherence in the older adult.

Hypothesis: The hypothesis is that adherence to medicines in older adults is lower in some living conditions (those older adults living alone and undergoing visits from community nurses, and in Aboriginal communities) than in other living conditions (older adults living in retirement homes or residential care). The aim is to compare adherence in the older aged under these different residential conditions.

Approaches: A questionnaire will be designed to be used in the study. Ethical approval will be sought from the Human Ethics Committee. Contacts will be made with people working in each of these living conditions, and permission sought to undertake the study. The study will then be undertaken in each of these living conditions.

References:

  1. Paes AHP, Bakker A, Soe-Agnie CJ. Diabetes Care 1997, 20, 1512-7.
  2. Gray SL, Mahoney JE, Blough DK. Ann Pharmacotherapy 2001, 35, 539-45.
  3. Hoy WE, Kondalsamy-Chennakesan, Nicol JL. Medical J Australia 2005, 183:305-9.
  4. Doggrell SA, Mearns G. Adherence to medicines in older adults. New Zealand Pharmacy 2005, 25 (11) 29-33
Study level
Honours
Supervisors
QUT
Organisational unit

Science and Engineering Faculty

Research area

Medical Sciences

Contact
Please contact the supervisor.