Abstract
Introduction
In older adults, medicines non-adherence is prevalent and harmful. Current methods of identification have limitations with direct questioning often being met with a reluctance to “admit” non-adherence to healthcare professionals. The Making Medicines Work for You screener has been developed to support patients and clinicians identify and discuss adherence issues in a clinical setting. This study aimed to pilot the screener and identify barriers to medication adherence in an unspecified geriatric outpatient population.
Method
Patients attending the Older Person’ Assessment Unit at a large London teaching hospital between June – October 2022 completed the 7-item paper-based screener, with the support of a carer or researcher where necessary. Descriptive analysis was used to determine the incidence and type of barriers to adherence. Associations and correlations between the screener and existing measure of adherence and medicines beliefs were assessed using Chi square and Spearman’s Rank, respectively.
Results
Of 245 patients approached, 226 consented to participate: 120 (53.1%) male; mean age 78.3 years (SD 6.7 years). 64 (28.3%) reported having someone help with their medicines and 67 (29.6%) used a multicompartment compliance aid. 193 barriers were reported: 115 (50.9%) identified at least one barrier to adherence (median 1, range 0-5). “I’ve found my own way to use my medicines” (n=53, 27.5%) and “I sometimes forget to take my medicines” (n=45, 23.3%) were the most frequently reported barriers. The screener demonstrated strong association with MARS5 (p<0.001), and moderate correlations with the MARS5 (r -0.34, p<0.001) and BMQ Concerns (r 0.29, p<0.001).
Conclusion
Despite support with medication being common, half of the participants reported barriers to medication adherence. The high rate of completion, strong association and moderate correlation with existing adherence measures suggest that the screener may have value in this setting. Further work is required to explore the barriers identified and develop appropriate interventions.