A recent analysis of publish studies examine the clinical consequences of medication adherence. The British Journal of Clinical Pharmacology analysis found that medication adherence is link with lower risks of needing; hence to be hospitalisation and of dying early. Medication adherence is define as the process by which patients take their medication as prescribe; consisting of 3 main components: initiation, implementation and discontinuation.
So the medication non‐adherence includes non‐initiation of treatment, suboptimal implementation of the regimen, or early discontinuation of treatment. Medication non‐adherence may represent a greater risk in older people, resulting in poorer health outcomes compared to younger cohorts. Drug‐relate factors, such as dosing regimen; side effects and polypharmacy, and patient relate factors; such as cognitive function, health literacy and multimorbidity, are barriers to medication adherence in this group.
In general, research to date on medication non‐adherence has been disease‐specific; assessing the impact of suboptimal adherence on surrogate health outcomes such as blood pressure, cholesterol levels and biological response. As multimorbidity increases with age, a disease‐specific perspective may not be appropriate for older cohorts.
In 2002, a meta‐analysis of the influence of adherence on health outcomes conclude that adherent people were nearly 3 times more likely to experience a positive treatment outcome than non‐adherent people. However, this meta‐analysis was not limit to medication adherence, include surrogate outcomes; also did not provide an estimate specific to older people.
Having a hospitalisation
A review of the barriers to good medication adherence in older people note a lack of well design studies of adherence in this population and called for future research to assess clinical outcomes associated with non‐adherence. Individuals aged 50 years and older who were considered to have good medication adherence had a 17% lower risk of having a hospitalisation due to any cause compared with those considered non-adherent.
Good adherence was also associated with a 21% reduction in long-term mortality risk compare with medication non adherence. “This review has provided a comprehensive and systematic assessment of the evidence on the association between medication non adherence and adverse health outcomes in older populations. It has highlighted the critical need for further research in this area,” the authors wrote.