title: Self-Reported Medication Adherence Barriers Among Ambulatory Older Adults with Mild Cognitive Impairment.
abstract: OBJECTIVE
  To compare the frequencies of barriers to medication adherence reported by ambulatory older adults with a diagnosis of mild cognitive impairment (MCI) and ambulatory older adults with normal cognition.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Outpatient clinics within a safety-net health care system.
  
  
  METHODS
  Ambulatory older adults (≥ 65 yrs) with a diagnosis of MCI (96 participants) or normal cognition (104 participants).
  
  
  RESULTS
  Self-reported beliefs and barriers to medication nonadherence were assessed by items from the Morisky Medication Adherence Survey, the Adherence Estimator, and barriers derived from a systematic review of studies in older adults with cognitive impairment. Participants with a diagnosis of MCI had a mean age of 72 years, 77% were female, and 37% were African-American. Participants with normal cognition had a mean age of 76 years, 79% were female, and 47% were African-American. Among all participants, 83% reported the presence of at least one barrier to medication adherence, and 62.5% reported two or more barriers to medication adherence. The most commonly reported barriers were difficulty remembering the amount or time of each medication to take (49%), difficulty opening or reading prescription bottles (42%), feeling worse when taking medications (29%), and trouble affording medications (26%). Considering the multiple comparisons made in this analysis, few significant differences in barrier frequencies were identified between the groups with MCI and normal cognition.
  
  
  CONCLUSIONS
  Multiple medication adherence barriers were identified among all participants, including cognitive, physical, and financial barriers, although few significant differences were identified between those with and without MCI. Interventions capable of addressing multiple barriers are required to improve medication adherence in older adults with and without MCI.
authors.affiliation: College of Pharmacy, Purdue University, West Lafayette, Indiana.|Indiana University Center for Aging Research, Indianapolis, Indiana.|Regenstrief Institute Inc., Indianapolis, Indiana.|Department of Pharmacy, Eskenazi Health, Indianapolis, Indiana.
authors.forename: Noll L
authors.initials: NL
authors.lastname: Campbell
authors.affiliation: Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Jia
authors.initials: J
authors.lastname: Zhan
authors.affiliation: Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Wanzhu
authors.initials: W
authors.lastname: Tu
authors.affiliation: College of Pharmacy, Purdue University, West Lafayette, Indiana.
authors.forename: Zach
authors.initials: Z
authors.lastname: Weber
authors.affiliation: Regenstrief Institute Inc., Indianapolis, Indiana.
authors.forename: Roberta
authors.initials: R
authors.lastname: Ambeuhl
authors.affiliation: Center for Observational and Real World Evidence, Merck Research Labs, Merck & Co. Inc., West Point, Pennsylvania.
authors.forename: Caroline
authors.initials: C
authors.lastname: McKay
authors.affiliation: Center for Observational and Real World Evidence, Merck Research Labs, Merck & Co. Inc., West Point, Pennsylvania.
authors.forename: Newell
authors.initials: N
authors.lastname: McElwee
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000375:Aging; D058070:Asymptomatic Diseases / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D002908:Chronic Disease / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D060825:Cognitive Dysfunction / Q000453:epidemiology / Q000503:physiopathology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D016527:Drug Costs; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007196:Indiana / Q000453:epidemiology; D008297:Male; D055118:Medication Adherence; D010044:Outpatient Clinics, Hospital; D064876:Safety-net Providers; D057566:Self Report
keywords: medication nonadherence; mild cognitive impairment