Adherence to Medication in Neurogeriatric Patients : Insights from the NeuroGerAd Study

ORCID
0000-0003-2913-9535
Affiliation
Department of Geriatrics, Halle University Hospital, 06120 Halle, Germany
Schönenberg, Aline;
GND
1290798923
Affiliation
Department of Neurology, Jena University Hospital, 07747 Jena, Germany
Mühlhammer, Hannah M.;
GND
1216191093
Affiliation
Institute for Medical Statistics, Computer and Data Sciences, Jena University Hospital, 07747 Jena, Germany
Lehmann, Thomas;
GND
137373155
ORCID
0000-0002-6423-3108
Affiliation
Department of Neurology, Jena University Hospital, 07747 Jena, Germany
Prell, Tino

Nonadherence to medication is associated with increased morbidity, mortality, and healthcare costs, especially in older adults with higher chances of multimorbidity. However, comprehensive data on factors influencing adherence in this patient group are rare. Thus, data for 910 patients were acquired, including demographic data, nonadherence (Stendal Adherence to Medication), depression (Beck Depression Inventory), cognition (Montreal Cognitive Assessment), personality (Big Five Inventory), satisfaction with healthcare (Health Care Climate Questionnaire), quality of life (36-item Short Form Survey), mobility, diagnoses, and medication. Elastic net regularization was used to analyze the predictors of adherence. Principal component and general estimation equations were calculated to analyze the underlying patterns of adherence. Only 21.1% of patients were fully adherent. Nonadherence was associated with male gender, higher number of medications, diagnosis, depression, poor patient–physician relationship, personality, impaired cognition, and impaired mobility. Nonadherence was classified into three sub-factors: forgetting (46.2%), missing knowledge about medication (29%), and intentional modification of medication (24.8%). While depression exerted the strongest influence on modification, a high number of medications was associated with missing knowledge. The different patterns of nonadherence (i.e., modification, missing knowledge, and forgetting) are influenced differently by clinical factors, indicating that specific approaches are needed for interventions targeting adherence.

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