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Prevalence and predictors of medication non‐adherence among older community‐dwelling people with chronic disease in Singapore
Author(s) -
Chew Suet Mei,
Lee Jia Hua,
Lim Su Fee,
Liew Min Jia,
Xu Yi,
Towle Rachel Marie
Publication year - 2021
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.14913
Subject(s) - medicine , medication adherence , cross sectional study , public health , chronic disease , older people , community health , disease , gerontology , family medicine , nursing , pathology
Aims To determine the prevalence and predictors of medication non‐adherence among older community‐dwelling people with at least one chronic disease in Singapore. Design A single‐centre cross‐sectional study. Methods The study was conducted in the largest tertiary public hospital in Singapore between May 2019 and December 2019. The community nurses of the hospital recruited a total of 400 community‐dwelling older people aged ≥60 years old, who were diagnosed with at least one chronic disease and prescribed with at least one long‐term medication. Medication non‐adherence was assessed using the self‐report 5‐item Medication Adherence Report Scale, operationalized as a score of <25. A list of potential factors of medication non‐adherence was structured based on the World Health Organization five‐domain framework and collected using a self‐report questionnaire. Results Sixty percent ( n = 240) of our participants were non‐adherent to their medication regime. Older people who smoked (OR 2.89, 95% CI 1.14–7.33), perceived their medication regime as being complicated (OR 2.54, 95% CI 1.26–5.13), felt dissatisfied with their regime (OR 2.50, 95% CI 1.17–5.31), did not know the purpose of all their medications (OR 2.56, 95% CI 1.42–4.63) and experienced side effects (OR 3.32, 95% CI 1.14–9.67) were found to be predictive of medication non‐adherence. Conclusion Medication adherence was found to be poor in community‐dwelling older people in Singapore. The predictors identified in this study can help guide healthcare professionals in identifying older people who are at risk of medication non‐adherence and inform the development of interventions to improve adherence. Impact Medication non‐adherence, especially in the older population with chronic diseases, constitutes a serious problem as it undermines the efforts to reduce morbidity and mortality associated with the underlying chronic diseases. To improve adherence, our findings propose the importance of assessing the older person's treatment satisfaction, which includes examining the aspects of side effects, effectiveness and convenience. Additionally, we highlight the need to address the older person's medication knowledge deficit.