Abstract
PurposeThe objective of this survey was to measure adherence and to identify correlation and prediction factors related to noncompliance among the elderly in Tehran, Iran. MethodsA population-based survey was carried out among the elderly (≥60 years of age) by using Tehran Epilepsy registry. All subjects were contacted by telephone and invited for face-to-face consultation. Questionnaires used were the following: Medication Adherence Rating Scale (MARS); Medical Prescription Knowledge (MPK); Abbreviated Mental Test (AMT). Along with customary descriptive statistics, a simple chi-square test (or Fischer exact test if value of cells was ≤5) was used for correlating; Cramer's V was used for strength of association, and prediction was by logistic regression. ResultsOut of 104 subjects’ approached, 23 subjects (median age 62.0, 95% CI 61.0–64.7, range 60–71; 73.9% males; 78.3% married and having a living partner; 54.5% epilepsy as supernatural; 21.7% with comorbid condition) participated. Most did not have a recent epilepsy onset (n=20, 86.8%), or had active epilepsy (n=22, 95.7%), convulsive seizures (n=21, 91.3%), with no (n=13, 56.5%) to low seizure number, and polytherapy (n=12, 52.2%). Median MARS score was 8.0 (95% CI 6.0–8.0, range 3–10). Nonadherence was correlated to comorbidity (p=0.003) and widowhood or divorcehood (p=0.04) and predicted by the same factors. Treatment side effects altered behavior (p=0.03), and unsteadiness (p=0.01) was also associated with nonadherence. MPK was positive for all participants. Median AMT score was 9.0 (95% CI 9.0–10.0, range 6–10). ConclusionElderly patients had a high treatment adherence and, as logically expected, were associated with comorbid state, divorce-widowhood, and drug-related behavioral side effects particularly behavioral and unsteadiness.
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