title: The AdHOC Study of older adults' adherence to medication in 11 countries.
abstract: OBJECTIVE
  Authors investigated, cross-nationally, the factors, including demographic, psychiatric (including cognitive), physical, and behavioral, determining whether older people take their prescribed medication. Older adults are prescribed more medication than any other group, and poor adherence is a common reason for non-response to medication.
  
  
  METHODS
  Researchers interviewed 3,881 people over age 65 who receive home care services in 11 countries, administering a structured interview in participants' homes. The main outcome measure was the percentage of participants not adherent to medication.
  
  
  RESULTS
  In all, 12.5% of people (N=456) reported that they were not fully adherent to medication. Non-adherence was predicted by problem drinking (OR=3.6), not having a doctor review their medication (OR=3.3), greater cognitive impairment (OR=1.4 for every one-point increase in impairment), good physical health (OR=1.2), resisting care (OR=2.1), being unmarried (OR=2.3), and living in the Czech Republic (OR=4.7) or Germany (OR=1.4).
  
  
  CONCLUSIONS
  People who screen positive for problem drinking and who have dementia (often undiagnosed) are less likely to adhere to medication. Therefore, doctors should consider dementia and problem drinking when prescribing for older adults. Interventions to improve adherence in older adults might be more effective if targeted at these groups. It is possible that medication-review enhances adherence by improving the doctor-patient relationship or by emphasizing the need for medications.
authors.affiliation: Camden and Islington Mental Health and Social Care Trust, Dept. of Mental Health Sciences, University College London, Archway Campus, Holborn Union Building, Highgate Hill, London N19 5NL, UK.
authors.forename: Claudia
authors.initials: C
authors.lastname: Cooper
authors.forename: Iain
authors.initials: I
authors.lastname: Carpenter
authors.forename: Cornelius
authors.initials: C
authors.lastname: Katona
authors.forename: Marianne
authors.initials: M
authors.lastname: Schroll
authors.forename: Cordula
authors.initials: C
authors.lastname: Wagner
authors.forename: Daniela
authors.initials: D
authors.lastname: Fialova
authors.forename: Gill
authors.initials: G
authors.lastname: Livingston
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D018153:Czech Republic / Q000453:epidemiology; D003710:Demography; D004358:Drug Therapy / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology