Medicine-taking practices in community-dwelling people aged > or =75 years in New Zealand.
BACKGROUND
older people experience more chronic medical conditions than younger people, take more prescription medicines and are more likely to suffer from cognitive or memory problems. Older people are more susceptible to the adverse effects of medicines, which may reduce their quality of life or lead to hospitalisation or death.


OBJECTIVE
this study aims to identify medicine-taking practices amongst community-dwelling people aged > or =75 years in New Zealand.


METHODS
this study was carried out in an urban setting in Dunedin (population 120,000), New Zealand. Interviews of a random sample of people from the electoral roll using a structured questionnaire were conducted. Subjects were community-dwelling people aged > or =75 years taking one or more prescription medicines. From a random sample of 810 people extracted from the electoral roll intended to recruit 300 participants, 524 people met the study criteria and were invited to participate. People living in a rest home or hospital, not contactable by telephone, or now deceased, were excluded. Responses were analysed, medicines categorised by the Anatomical Therapeutic Chemical classification and adherence classed as high, medium and low using a modified four-item Morisky Medication Adherence Scale. Univariate and multivariate linear and logistic regression was applied to combinations of variables.


RESULTS
in total, 316 interviews were undertaken; a 61% response rate. Participants were 75-79 (35%), 80-84 (40%) and >85 years (25%); New Zealand European/European (84%), 'New Zealanders' (14%) or Maori (2%); and 141 (45%) lived alone. Almost half (49%) regularly saw a specialist and a third (34%) had been admitted to hospital in the past 12 months. Participants used a median of seven prescription medicines (range 1-19) and one non-prescription medicine (0-14). The majority (58%) believed medicines are effective and had systems/routines (92%) for remembering to take them. Doses tended to be missed following a change in routine, e.g. holiday. Men were more likely to report 'trouble remembering' than women (odds ratio = 1.86, 95% confidence interval 1.10-3.14; P = 0.020). Seventy-five percent of people had high or medium adherence scores and 25%, low scores. Common problems were reading and understanding labels (9 and 4%, respectively) and leaflets (12%, 6%), and difficulty swallowing solid dose forms (14%). Only 6% had problems paying for their medicines. Around 17% wanted to know more about their medicines, and some people were confused about their medicines following hospital discharge.


CONCLUSIONS
overall, community-dwelling people aged > or =75 years in this study appeared to manage their medicines well and found them affordable. Nevertheless, there is a need to improve labelling, leaflets and education on medicines, particularly at hospital discharge.
Tordoff
June M
JM
School of Pharmacy, University of Otago, 18 Frederick Street, Dunedin 9054, Otago, New Zealand. june.tordoff@otago.ac.nz
Bagge
Michael L
ML
Gray
Andrew R
AR
Campbell
A John
AJ
Norris
Pauline T
PT
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002908:Chronic Disease / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology*; D003679:Deglutition; D016527:Drug Costs / Q000706:statistics & numerical data; D004348:Drug Labeling / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000453:epidemiology; D009520:New Zealand / Q000453:epidemiology; D010349:Patient Compliance / Q000706:statistics & numerical data; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012646:Self Administration / Q000191:economics / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data; D016903:Drug Monitoring