Polypharmacy and barriers to medication adherence among the elderly with chronic diseases attending a tertiary care hospital in Rawalpindi

ABSTRACT

Background:
Taking a number of medicines, whether they are prescription drugs, OTC drugs, an herbal or dietary supplement is known as polypharmacy. The elderly are susceptible to multiple chronic conditions, and are at a greater risk to polypharmacy; hence they face a number of problems adhering to their treatment plan. The purpose of this study was to evaluate barriers to medication adherence faced by the elderly with chronic diseases and to find and its association with polypharmacy.

Materials and Methods:
The cross sectional study was done within six months in a tertiary care hospital of Rawalpindi, Pakistan. Descriptive analysis was done by calculating frequency and percentages; Chi-square test was applied in inferential analysis for the variables of interest to determine statistical association.

Results:
Data was collected from a total of 173 respondents. Mean age of the respondents who participated in the study was found to be 69.12±7.6, the average number of years from which they were suffering from the disease was 14.32±6.6. Out of 173 respondents, (84.4%) N=146 were males and 15.6% N=27 were females. Among the four barriers 121 (69.9%) respondents faced patient related factors,126(72.8%) faced healthcare system related factors,114(65.9%) faced socio-economic factors,82(47.4%) faced therapy related factors and 74(42.8%) faced condition related factors.

Conclusion:
This study identified barriers to medication adherence faced by the elderly due to polypharmacy. A significant association was found between number of medicines taken by the elderly and the associated barriers. Polypharmacy causes difficulty adhering to treatment, as age increases so does the diseases especially in the elderly, which is the main cause of increasing number of medicines taken by the elderly and hence increased barriers to adherence. The use of multiple drugs may be appropriate for some individuals, but inappropriate for others. Strategies should be made by the public health professionals and should be implemented by the health care professionals while choosing therapies to assess the risk, benefit ratio of the treatment given especially in elderly with multi morbidities.