Do geriatric outpatients adhere to medication changes advised after assessment? An exploratory pilot study.
BACKGROUND
The most frequent intervention after Comprehensive Geriatric Assessment (CGA) is adjustment of medications. Adherence to recommendations is often incomplete. Patients at high risk of non-adherence should be identified.


OBJECTIVE
To explore if changes in drug-use after CGA are carried out by the patient. To identify factors influencing non-adherence.


METHODS
Co-morbidity and medication use were recorded. Patients, and when cognitively impaired, a caregiver, were questioned about advised changes. Drug-use before and after CGA was assessed. Patients were asked whether they would discontinue their drugs either with or without consulting their physician. Univariate logistic regression analysis to identify factors influencing non-adherence, was performed with SPSS.


RESULTS
Forty patients were included. Of the changes in medication advised, 90 % were reported to be carried out. 65 % of the patients were compliant. Only the presence of a caregiver was associated with reported complete adherence to drug therapy. Most patients can't describe for how long they will have to continue taking the drugs that are prescribed to them.


CONCLUSIONS
Most geriatric patients carry out changes in medication made after CGA. Supervision by caregivers may explain a high rate of reported adherence despite the presence of polypharmacy and cognitive decline.


CONCLUSIONS
In the absence of caregivers special attention should be paid to adherence to medication changes. Information about intended duration of drug therapy should be improved.
Tulner
Linda R
LR
Department of Geriatric Medicine, Slotervaart Hospital, Louwesweg 6, 1066 EC Amsterdam, The Netherlands. geltu@slz.nl
Frankfort
Suzanne V
SV
Wesselius
Floor
F
van Campen
Jos P C M
JP
Koks
Cornelis H W
CH
Beijnen
Jos H
JH
D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D003072:Cognition Disorders / Q000150:complications*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D010045:Outpatients / Q000523:psychology / Q000706:statistics & numerical data; D010865:Pilot Projects; D019338:Polypharmacy; D011446:Prospective Studies; D016903:Drug Monitoring