INTENTIONAL NON-ADHERENCE TO MEDICATIONS IN THE ELDERLY - RESULTS FROM A PILOT STUDY (WARSAW, POLAND)

Abstract

Background Non-adherence is a common phenomenon, which is usually underestimated. The distinction between intentional and erratic non-adherence is important since it requires different actions; however, this issue is rarely addressed in studies. The aim of the study was to assess adherence to longterm medication and the effect of selected factors on the occurrence of intentional non-adherence, including intentional discontinuation of therapy among the elderly. Methods Members of the Warszawa-Wawer University of the Third Age in Warsaw, Poland, over 60 years old were enrolled in the study. Adherence was assessed with the use of the Medication Adherence Rating Scale (MARS). In addition, the Treatment Burden Questionnaire (TBQ) and Euro-Quality of Life Questionnaire (EQ-5D) were used, with a determination of medication information needs, expected medication effect, experienced problems/difficulties, reported concerns, and potential causes of therapy discontinuation. Statistical analysis was performed with the use of STATISTICA software version 13.3. Results Self-reported adherence is underestimated (30% rate among participants); as many as half of the participants allowed self-discontinuation of therapy. Patients burdened with treatment, using numerous medications, should be a priori treated as susceptible to non-adherence. The occurrence of problems and difficulties in relation to therapy may contribute to intentional non-adherence, or even to intentional discontinuation of therapy. Conclusions Non-adherence requires a distinction between different types of non-adherence. Patients should be given information about their medications, according to their needs: Their ideas, problems, and concerns should be verified in order to prevent intentional modification of therapy.