The association between frailty and medication adherence among community-dwelling older adults with chronic diseases: Medication beliefs acting as mediators

Abstract

ObjectiveTo explore the association between frailty and medication adherence by modeling medication beliefs (i.e., necessity and concerns) as mediators among community-dwelling older patients. MethodsThis cross-sectional study was conducted among 780 Chinese older patients. Frailty, medication adherence and medication beliefs were assessed using the Comprehensive Frailty Assessment Instrument (CFAI), the 4-item Morisky Medication Adherence Scale (MMAS-4) and the Beliefs about Medicines Questionnaire-Specific (BMQ-Specific), respectively. The PROCESS SPSS Macro version 2.16.3, model 4 was used to test the significance of the indirect effects. ResultsFrailty was associated with high medication necessity (β = 0.091, p = 0.011) and high medication concerns (β = 0.297, p < 0.001). Medication adherence was positively associated with medication necessity (β = 0.129, p = 0.001), and negatively associated with medication concerns (β = −0.203, p < 0.001). Medication necessity and medication concerns attenuated the total effect of frailty on medication adherence by −13.6% and 70.3%, respectively ConclusionHigh medication concerns among frail older patients inhibit their medication adherence, which cannot be offset by the positive effect of their high medication necessity on medication adherence. Practice implicationsInterventions should target medication beliefs among frail older patients, particularly medication concerns, to efficiently improve their medication adherence.