Factors associated with adherence to pharmacological treatment among elderly persons using antihypertensive drugs

Association of health anxiety, fatalism and medication adherence among geriatric clients: An exploratory study

OBJECTIVES

This study explored the relationship between health anxiety, fatalistic beliefs, and medication adherence among geriatric clients. Also, it determines the extent to which health anxiety and fatalism can predict the variance in medication adherence among the same population of geriatric clients.

DESIGN

A cross-sectional analytical survey on 200 eligible participants using the Arabic Version of the Short Health Anxiety Inventory, Fatalism Scale, and Morisky Medication Adherence Scale-8 items.

RESULTS

The study found a statistically significant negative relationship between the studied geriatric clients' fatalism and health anxiety and their medication adherence (r = -0.160, - 0.187, and P = 0.024, 0.008), respectively.

CONCLUSION

This study highlights the importance of considering psychological factors such as health anxiety and fatalistic beliefs in addressing medication adherence among geriatric clients. By addressing these factors, healthcare providers can develop more effective strategies to improve medication adherence and ultimately improve the health outcomes of geriatric clients.

Examining the relationship between depression and medication adherence among elderlies suffering from cardiovascular disease referring to the clinics affiliated with Kermanshah University of Medical Sciences: A cross-sectional study

Background

In recent years, around 30% of all mortalities worldwide has been related to cardiovascular disease (CVD). The most important predictor solution of cardiovascular events is enhancing medication adherence. Meanwhile, the main reason behind development of physical disorders among the elderly is depression. In this regard, the present research was performed to determine the relationship between depression and medication adherence among the elderly suffering from CVD.

Methods

A cross-sectional study was done via an analytical approach on 188 elderlies fulfilling the inclusion criteria. The participants were chosen through convenience nonrandomized sampling from March to July 2022. The data were collected through demographic and healthcare information form plus Madanloo chronic disease medication adherence and geriatric depression scale. The analysis of the data was done by SPSS 26 plus Stata 14.2.

Results

The mean depression score was 5.6(4.3) and the mean score of medication adherence in the elderlies was 168.03(23.85). The prevalence of depression was higher in women than in men (p = 0.015), and the elderlies differing from heart failure reported the minimum extent of medication adherence. The findings obtained from analysis of variance showed that age, level of education, and monthly level of income were among the effective demographic factors in the extent of depression and medication adherence (p < 0.05). Meanwhile, 26% of changes in medication adherence can be attributed to depression. Further, the results of the multiple linear regression model reported that depression, age, and polypharmacy are among the predictors of medication adherence.

Discussion and Conclusion

A weak to moderate relationship existed between depression and medication adherence among these elderlies. Given the growing elderly population, the importance of depression, and lack of medication adherence in incidence of CVD events, it is recommended to train the healthcare team to monitor the elderly regarding depression symptoms.

Health literacy and adherence to the pharmacological treatment by people with arterial hypertension

OBJECTIVE

To analyze the association between health literacy and the adherence to the pharmacological treatment of Brazilians with arterial hypertension.

METHODS

Cross-sectional study with 234 participants who responded an on-line sociodemographic and clinical characterization questionnaire, in addition to evaluation of health literacy and of the adherence to their pharmacological treatment. Data were analyzed using descriptive statistics and difference and correlation tests.

RESULTS

People with post-graduation, who were actively working and did not smoke, had better health literacy results. Elders and those who were retired or lived on government subsidies adhered better to the medication treatment. There was a correlation between the numerical dimension (rs=0.189; p=0.004) and the global health literacy result (r2=0.170; p=0.009) with the adherence.

CONCLUSIONS

A better numerical and global understanding of health literacy was associated with better adherence to arterial hypertension medication treatment.

Letramento em saúde e adesão ao tratamento farmacológico de pessoas com hipertensão arterial

RESUMO Objetivo: Analisar a associação entre o letramento em saúde e a adesão ao tratamento farmacológico de brasileiros com hipertensão arterial. Métodos: Estudo transversal, desenvolvido com 234 participantes, que responderam um questionário on-line de caracterização sociodemográfica, clínica, avaliação do letramento em saúde e da adesão ao tratamento farmacológico.Os dados foram analisados com estatística descritiva e testes de diferença e correlação. Resultados: Pessoas com pós-graduação, que trabalhavam e não tabagistas obtiveram melhores resultados de letramento em saúde. Idosos e aposentados/pensionistas apresentaram melhor adesão ao tratamento medicamentoso. Houve correlação entre a dimensão numérica (rs=0,189; p=0,004) e o resultado global de letramento em saúde (rs = 0,170; p=0,009) com a adesão. Conclusões: Melhor compreensão numérica e global de letramento em saúde estiveram associados a melhores resultados de adesão ao tratamento medicamentoso da hipertensão arterial.

Factors Associated with Frailty Syndrome in Older Adults

OBJECTIVE

Frailty is a common geriatric syndrome, characterized by a decrease in energy reserve and stress resistance, resulting in an accumulated decline of multiple physiological systems and greater vulnerability. Frailty syndrome has a multifactorial etiology involving a biological basis associated with sociobehavioral factors. We verify the association of frailty syndrome with family functionality level, nutritional status and medication adherence in older adults.

DESIGN

Observational and analytical study.

SETTING AND PARTICIPANTS

Conducted at ambulatory the university hospital, with patients aged 60 years or older.

MEASUREMENTS

Cognitive function was measured using the Mini-Mental State Examination (MMSE); nutritional status was evaluated using the Mini Nutritional Assessment (MNA) and Body Mass Index, BMI; the 5-item FRAIL scale was used for frailty screening; family functioning was assessed using the Family APGAR Index, which evaluates Adaptability, Partnership, Growth, Affection, and Resolve; Self-reported medication adherence was measured by the eight-item Morisky Medication Adherence Scale (MMAS-8).

RESULTS

The study involved 308 older adults, with a mean age of 70.40 years, There was an association between frailty and highly dysfunctional family with an OR of 5.9 (95% CI 1.9-18.5)(p<0.05), nutritional risk assessed by BMI, where low weight presented an OR of 2.5 (95% CI 1.1-5.8) and obesity an OR of 2.8 (95% CI 1.1-7.0)(P <0.05) and a nutritional risk assessed by MNA with an OR 6.3(95% CI 1.9-20.4) and low medication adherence with an OR of 8.9 (95% CI, 3.6-21.6)(P = 0.01).

CONCLUSION

Frailty syndrome is associated with high levels of family dysfunction, nutritional risk and poor medication adherence amongst older people.

Evaluation of the clinical-functional vulnerability index in older adults

Abstract Objective: To evaluate the clinical-functional vulnerability index (CFVI) of older adults and its relationship with socioeconomic, behavioral, clinical and therapeutic indicators. Method: A cross-sectional epidemiological study with a quantitative design was performed with 318 randomly drawn older adults registered with the Family Health Strategy. Data were collected through the CFVI-20 questionnaire and analysis was supported by descriptive, bivariate and multivariate statistics, with results with p-value <0.05 considered significant. Results: most older adults (59.1%) were considered frail or potentially frail. Among the groups studied, there was a statistically significant difference in the CFVI for the variables age group (p<0.001), functional literacy (p=0.001), alcohol consumption (p<0.001), physical exercise (p<0.001), self-reported health problems (p<0.001) and medication use (p<0.001), as well as a positive correlation with stress (r=0.135; p=0.016). In the multiple linear regression model, the set of sociodemographic predictor variables explained the frailty of the elderly by 30.4% (R2=0.304). Conclusions: The advancement of age, as a non-controllable variable, indicates a need to encourage the maintenance of functionality in old age, based on the health care strategies that prolong longevity with safety, autonomy and vitality.

Association between follow-up in health services and antihypertensive medication adherence

OBJECTIVE

To analyze the association between the characteristics of follow-up in health services and adherence to antihypertensive medication in patients with cardiovascular disease.

METHOD

Analytical study carried out with 270 patients suffering from hypertension and hospitalized due to cardiovascular complications. Data collection occurred between November 2015 and April 2016, involving sociodemographic variables, presence of self-reported diabetes, accessibility and use of health services, blood pressure levels and medication adherence (analyzed through the Morisky-Green Test).

RESULTS

The rate of adherence to antihypertensive therapy was 63.0%. Enrollment in the Hiperdia program had no statistical significance to medication adherence. People who attended at least between 4 and 6 nursing consultations throughout the data collection period (p = 0.02) had better adherence.

CONCLUSION

The study's findings provide support for the reorientation of health services and their public policies towards improving adherence to antihypertensive therapeutics.