ADHERENCE AND BARRIERS TO DRUG THERAPY: RELATIONSHIP WITH THE RISK OF FALLS IN OLDER ADULTS

Cristiane Regina Soares,Meiry Fernanda Pinto Okuno,Paula Cristina Pereira da Costa,Vanessa Ribeiro Neves,Anderson da Silva Rosa,Marcia Maiumi Fukujima

doi:10.1590/1980-265x-tce-2020-0552

Cristiane Regina Soares, Meiry Fernanda Pinto Okuno + Show 4 more

Open Access

https://doi.org/10.1590/1980-265x-tce-2020-0552

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Abstract

ABSTRACT Objective: to verify the association of adherence and barriers to drug therapy with the risk of falls and the sociodemographic, clinical and economic variables. Method: a cross-sectional study, carried out with 117 aged individuals in a Medical Clinic of Specialties for Older Adults in the Southeast region of the city of São Paulo (SP), from March to November 2019. The following scales were applied: Downton Fall Risk, Morisky-Green Test and Brief Medication Questionnaire. Logistic regression was use to verify the association between adherence to the treatment and types of barriers to adherence and the risk of falls. A 5% significance level was used. Results: the older adults with low adherence to the drug treatment presented 5.57 times more chances of having a high risk of falling when compared to those with greater adherence, and those with a barrier in the recall domain had 22.75 times more chances of having a high risk of falling, in relation to the aged individuals without barriers in the recall domain. Conclusion: low and average adherence to drug therapy and the barrier related to the recall domain were associated with high risk of falls in the older adults.

Highlights

The Brazilian population is expected to continue growing, with estimated life expectancy at birth of 71.3 years for men and 78.5 years for women in 2013 and, in 2060, 78.0 years for men and 84.4 years for women
Classification of adherence to the medications as high, average and low was based on the Morisky Green Test (MGT) scores, and 104 (88.8%) participants presented low to average adherence to the use of the drugs
In the older adults interviewed, we identified the use of medications similar to Fall Risk-Increasing Drugs (FRIDs), such as psychotropics, antidepressants, antipsychotics, antiepileptics, opioids, antihypertensives and diuretics, which can contribute to the onset of contributing signs and symptoms to the occurrence of falls

Summary

Introduction

The Brazilian population is expected to continue growing, with estimated life expectancy at birth of 71.3 years for men and 78.5 years for women in 2013 and, in 2060, 78.0 years for men and 84.4 years for women Along with these demographic changes, there are changes in the health and disease patterns, with an increase in Chronic Non-Communicable Diseases (NCDs), that is, people are aging, and most of them tend to have some NCDs1–4. Unintentional displacement of the body to a level below its starting position and without timely correction is called a fall. This phenomenon is determined by multifactorial circumstances, which can impair postural stability. Among the factors related to the occurrence of falls are the biological, behavioral, environmental and socioeconomic aspects[5,6,7,8]

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