IJCM_104A: Polypharmacy and medication adherence among elderly population in a rural area of Ernakulam district, Kerala.

Abstract

Background: Polypharmacy is the concurrent use of multiple medications. Although there is no standard definition, polypharmacy is often defined as the routine use of five or more medications. This includes over-the-counter, prescription and/or traditional and complementary medicines used by a patient Objective: The aim of the study was to assess the prevalence of polypharmacy, describe the number and types of drugs used, and to determine medication adherence in elderly population Methodology: A cross sectional study was conducted among 364 elderly population residing in Vypin Block of Ernakulam district, Kerala by probability-proportional-to-size sampling. A semi structured questionnaire was administered by face-to-face interview to collect details on sociodemographic profile, regular medications and Morisky Medication-Taking Adherence Scale- MMAS (4-item) to assess medication adherence. The study participants were categorized into poor and good adherence based on MMAS score Results: More than half (53%) of the elderly were females, with a mean age of 69 ± 7 years. The prevalence of polypharmacy among the study population was 14.6% [95% CI, 11-18.2]. The most commonly used medications (35%) were oral blood glucose-lowering agents, followed by antihypertensive drugs and lipid-modifying agents. The vast majority (86.5%) had good medication adherence according to MMAS score. The independent determinants of medication adherence in our study were males (aOR=2.53 CI 1.09-5.08; p= 0.03) Christian religion (aOR=3.84 CI 1.43-10.34; p=0.008), staying along with family (aOR=8.15 CI 2.04-32.5; p=0.003), having polypharmacy (aOR=3.69 CI 1.54-2.82; p=0.003) and not having to pay for medications (aOR=3.4 CI 1.51- 7.64; p=0.003) were found statistically significant with medication adherence Conclusion: In order to improve medication adherence, the health care system should focus on women, those who stay alone and those who have to pay for medications