Regimen complexity and medication nonadherence in elderly patients.
OBJECTIVE
To assess whether the number of daily administrations of individual drugs, as a measure of regimen complexity, contributes to the profile of an elderly patient who adheres poorly to the prescribed therapy.


METHODS
Six hundred ninety patients over 64 years who were consecutively admitted to 11 acute medical care and three long term/rehabilitation wards in Italy.


METHODS
Self-reported adherence to drugs taken at home before admission was measured by a single question assessment for each listed drug supplemented with a latter question about the circumstances of the missed administration. For cognitively impaired patients the question was put to patients' relatives or caregivers.


METHODS
A structured multidimensional assessment was performed to identify nonadherence and its potential correlates. Correlates of nonadherence were identified by multivariable logistic regression.


RESULTS
We recorded 44 cases (6.4%) of nonadherence to at least one drug. Being assisted by foreign caregivers (OR 2.17; 95% CI 1.02-4.63) and the use of at least one multiple daily dosing drug (OR 2.99; 95% CI 1.24-7.17) were significant independent correlates of medication nonadherence, while age, selected indexes of frailty and the cumulative number of prescribed drugs were not.


CONCLUSIONS
Regimen complexity and type of assistance are independent correlates of medication nonadherence.
Corsonello
Andrea
A
Istituto Nazionale di Ricovero e Cura per Anziani (INRCA), Cosenza;
Pedone
Claudio
C
Lattanzio
Fabrizia
F
Lucchetti
Maria
M
Garasto
Sabrina
S
Carbone
Claudia
C
Greco
Cosetta
C
Fabbietti
Paolo
P
Incalzi
Raffaele Antonelli
RA