Medication Adherence In Elderly Patients Research Articles

Identifikasi Layanan Kesehatan yang dibutuhkan Pasien Lansia untuk Menunjang Kepatuhan Minum Obat

Healthcare services are one of the factors influencing the medication adherence of elderly patients. Therefore, in order to enhance the medication adherence of elderly patients, it is essential to understand the healthcare services required by the elderly, both from healthcare professionals and the healthcare system. This research aims to identify the necessary healthcare services for the elderly to improve their adherence. The method employed is in-depth interviews using validated interview guidelines, followed by analysis through thematic analysis. A total of 12 elderly patients suffering from diabetes mellitus were involved in this study, ranging in age from 56 to 70 years. The forms of healthcare services needed by these elderly patients include insurance-covered treatment costs with an easy and practical system, information about medications delivered by experts, the presence of methods or tools for medication reminder, healthcare professionals who understand the elderly, education about medications and diseases, as well as specialized facilities to obtain medications. This study is a qualitative research effort, with the hope that further research can be conducted to serve as a foundation for both central and regional governments in formulating policies related to the healthcare services required by the elderly.

Medication Adherence and Its Associated Determinants in Older Adults with Type 2 Diabetes and Cardiovascular Comorbidities.

To evaluate medication adherence level and identify predictors of poor medication adherence in elderly patients with Cardiovascular (CVS) diseases and type 2 diabetes in Jordan. This cross-sectional study was conducted on elderly patients who attended King Abdullah University Hospital (KAUH) outpatient diabetes and cardiology clinics from March 6, 2023, to July 6, 2023. Data on age, sex, socio-demographics, biological variables, medication characteristics, and chronic comorbidities were obtained from electronic patients' medical records and a validated questionnaire. Medication adherence levels (low, moderate, and high) were assessed using the Arabic version of the 4-item Morisky, Green, and Levine Medication Adherence Scale-Medication Assessment Questionnaire. Data from 506 elderly patients were analyzed. The average age of the participants was 67.93 years (SD = 6.22). 7.9% of patients showed low adherence levels, 33.6% showed moderate adherence level, and 58.5% of patients showed a high level of adherence toward their prescribed medications. Multivariable ordinal logistic regression analysis revealed that single/currently unmarried patients and patients who were living with others were more likely to have a higher adherence level; Odd Ratios (ORs) were 4.75 and 4.10, respectively. Patients who took their medications ≥ 3 and 2 times a day showed higher adherence to their medications than those who only took them once a day.; ORs were 2.15 and 2.36, respectively. This study indicated an inadequate level of adherence among patients with type 2 diabetes and cardiovascular comorbidities. This study revealed the necessity of implementing programs to help in raising the awareness among elderly patients with type 2 diabetes and CVDs of the importance of adherence to prescribed long-term medication regimens.

Factors Influencing Medication Adherence in Elderly Patients with Hypertension: A Single Center Study in Western China.

To develop and empirically test a conceptual model that explains the factors influencing antihypertensive medication adherence behavior in elderly patients in a city in western China. The conceptual model was based on the Theory of Planned Behavior and the Health Belief Model and was empirically tested using cross-sectional survey data from Nanchong City, a city in western China, collected between October and December 2020. Data were analyzed using structural equation modeling. Behavioral intentions were the main predictor of medication adherence behavior (path coefficient of 0.353). Perceived benefits and perceived barriers directly (path coefficient = 0.201 and -0.150, respectively), and indirectly (path coefficient = 0.118 and -0.060) through behavioral intentions, influenced medication adherence behavior. Perceived susceptibility (path coefficient = 0.390) and perceived severity (path coefficient = 0.408) influenced behavioral attitudes, which influenced behavioral intentions (path coefficient = 0.298). The conceptual model demonstrates a robust ability to predict and explain medication adherence behavior among elderly patients with hypertension, facilitating the adoption and maintenance of changes in adherence behavior and the potential for preventing disease progression and improving quality of life.

Factors Associated with Medication Adherence in Elderly Individuals with Tuberculosis: A Qualitative Study.

This qualitative study was conducted in two phases, using an integrative literature review and individual interviews. Studies were gathered without time restriction from MEDLINE databases, Institute for Scientific Information (ISI), Google Scholar, Scopus, and EMBASE, as well as national databases, including Scientific Information Database and Magiran. The findings of 38 studies that met the inclusion criteria were analyzed through the conventional content analysis method based on the ecological approach. After reviewing and forming the data matrix, purposive sampling was performed among healthcare professionals, elderly tuberculosis patients aged 60 and over, and family caregivers of elderly patients to conduct individual interviews. Data obtained from 20 interviews were analyzed using the directed content analysis method. After coding, the data from individual interviews were entered based on similarity and difference in the categories of data matrix obtained from the literature review. In general, the aforementioned codes were placed in four main categories, including individual factors (i.e., biological factors, affective-emotional factors, behavioral factors, cognitive factors, tuberculosis-related factors, and economic factors), interpersonal factors (i.e., patient's relationship with treatment team and family-related factors), factors related to healthcare service provider centers (i.e., medical centers' facilities and capacity building in healthcare service provider), and extraorganizational factors (i.e., social factors and health policymaking). The results of this study showed that medication adherence in elderly patients with tuberculosis was a complex and multidimensional phenomenon. Therefore, society, policymakers, and healthcare providers should scrutinize the factors affecting medication adherence in this group of patients to plan and implement more effective interventions.

The effect of comprehensive individual motivational-educational program on medication adherence in elderly patients with bipolar disorders: An experimental study.

The number of older adults with bipolar disorder is increasing and medication non-adherence is a major problem that negatively impacts the course of bipolar disorder. This study aimed to determine the effect of a comprehensive individual motivational-educational program on medication adherence in elderly patients with bipolar disorder. An experimental study with pretest-posttest repeated measures with a control group was conducted on two groups of 62 elderly people with bipolar disorders hospitalized at Ibn Sina Hospital in Mashhad, Northeast Iran, 2019. For the elderly in the intervention group, a comprehensive motivational-educational program was administered for one month (four 30-45 minute sessions), and for the elderly in the control group, routine clinical care was performed. Medication adherence in both elderly groups was measured before, immediately after, one and two months after the intervention. Data were analyzed by SPSS statistical software (version 16) using descriptive statistics and independent t-test, Mann-Whitney, paired t-test, repeated measures analysis of variance (ANOVA), and Chi-square tests. The mean age of elderlies in the intervention and control groups were 69.03 ± 5.75 and 68.50 ± 6.73 years, respectively. Regardless of the groups to which the patients were assigned, a significant difference in medication adherence scores was observed during the study period (time effect; P < 0.001). Also, the medication adherence score was significantly lower in the intervention group, compared to the control group (group effect; P < 0.001). Also, there was a group time interaction between the medication adherence score and the time of evaluation (P < 0.001). The results of the present study confirm the positive effect of a comprehensive educational-motivational program on improving medication adherence in elderly patients with bipolar disorder.

Associated Factors with Adherence Level of Elderly Patients with Hypertension to the Prescribed Medication

Background: More and more studies have emphasized the level of adherence among patients with hypertension during the last decades. Objective: The purpose of this study is to investigate the level of adherence of elderly patients with hypertension to the medication given to them. Methods: For this purpose, a quantitative synchronous study was performed on a sample of 73 elderly patients with hypertension. The Self-Efficacy For Appropriate Medication Use Scale [SEAMS] was used to evaluate medication adherence. Results: The findings of the study showed that elderly patients with hypertension show a moderate level of adherence to the medication. Age, years of starting treatment, and years of diagnosis were significantly associated with the level of medication adherence in elderly patients with hypertension. Conclusion: More studies are needed to highlight the factors that affect the level of adherence to the medication of elderly patients with hypertension.

A Smartphone App to Improve Oral Anticoagulation Adherence in Patients With Atrial Fibrillation: Prospective Observational Study.

BackgroundPoor adherence to oral anticoagulation in elderly patients with atrial fibrillation (AF) has been shown to negatively impact health care costs, morbidity, and mortality. Although various methods such as automated reminders, counseling, telephone support, and patient education have been effective in improving medication adherence, the burden on health care providers has been considerable. Recently, an attempt has been made to improve medication adherence without burdening health care providers by using smartphone apps; however, the use of the app for elderly patients with AF is still limited.ObjectiveThe purpose of this study was to determine whether the newly developed smartphone app for patients with AF (the Smart AF), which integrates education, automatic reminder, and patient engagement strategies with a simple user interface, can improve medication adherence in elderly patients with AF.MethodsPatient enrollment was carried out by obtaining informed consent from patients with AF attending Kyoto Prefectural University of Medicine hospital between May 2019 and September 2020. Follow-up was planned at 1, 3, and 6 months after enrollment, and questionnaire reminders were automatically sent to patient apps at designated follow-up time points. A questionnaire-based survey of medication adherence was performed electronically using the self-reported 8-item Morisky Medication Adherence Scale (MMAS-8) as the survey tool.ResultsA total of 136 patients with AF were enrolled in this study. During the follow-up period, 112 (82%) patients underwent follow-up at 1 month, 107 (79%) at 3 months, and 96 (71%) at 6 months. The mean age of the enrolled patients was 64.3 years (SD 9.6), and male participants accounted for 79.4% (108/136) of the study population. The mean CHADS2 (congestive heart failure, hypertension, age, diabetes, previous stroke, or transient ischemic attack) score was 1.2, with hypertension being the most common comorbidity. At the time of enrollment, 126 (93%) and 10 (7%) patients were taking direct oral anticoagulants and warfarin, respectively. For medication adherence as measured according to the MMAS-8, MMAS scores at 1 month, 3 months, and 6 months were significantly improved compared with baseline MMAS scores (all P values less than .01). The overall improvement in medication adherence achieved by the 6-month intervention was as follows: 77.8% (14/18) of the patients in the high adherence group (score=8) at baseline remained in the same state, 45.3% (24/53) of the patients in the medium adherence group (score=6 to <8) at baseline moved to the high adherence group, and 72% (18/25) of the patients in the low adherence group (score <6) moved to either the medium or high adherence group.ConclusionsThe Smart AF app improved medication adherence among elderly patients with AF. In the realm of medication management, an approach using a mobile health technology that emphasizes education, automatic reminder, and patient engagement may be helpful.

Assessment of physical function, quality of life, and medication adherence in elderly patients with rheumatic diseases

BackgroundThe proportion of older people in the total population has increased in Turkey as well as worldwide. As life expectancy rises, the increasing prevalence of rheumatic diseases poses major problems in the elderly. Comorbid diseases and the aging-induced changes in the endogenous immune response and the pharmacokinetic properties of therapeutic agents may complicate the decision to use a particular drug and result in a different clinical picture and treatment response. We, therefore, aimed to investigate the characteristics of chronic inflammatory diseases, their impact on physical function and quality of life, the prevalence of comorbid diseases that may complicate treatment planning, and treatment adherence in patients aged 65 years or older.ResultsOne hundred seventy-four patients were included and divided into two age groups: 18–64 years (group 1, n = 85) and 65 years or older (group 2, n = 89). The mean age of all recruited patients was 57.55 ± 16.98 years. Of 174, 99 (56.9%) were female and 75 (43.1%) were male. The mean duration of rheumatic disease was 7 ± 4.8 years and age at onset was 51.46 ± 14.78 years. Gender distribution differed significantly by age group (P = 0.024). The percentage of females in group 1 was 48.2% and 65.2% in group 2. The occupational status also differed significantly by age group (P < 0.001). 48.2% of group 1 were employed and 57.3% of group 2 were housewives. Marital status varied significantly by age (P < 0.001). The percentage of married was 74.1% in group 1 and the percentage of separated/divorced/widowed in group 2 was 28.1%. There was no difference between groups 1 and 2 in terms of place of residence (P = 0.459). The prevalence of comorbid diseases and the rate of use of medications for comorbid diseases (non-rheumatic treatments) were higher in elderly patients. The rate of use of disease-modifying anti-rheumatic drugs (DMARDs) was 30.3% and biological agents 61.8% in the elderly group (≥ 65 years) (group 2) (P < 0.001). There were positive correlations between, Health Assessment Questionnaire (HAQ), Bath Ankylosing Spondylitis Functional Index (BASFI) and Nottingham Health Profile (NHP) domains in both groups. There was also a significant negative correlation between Medication Adherence Rating Scale (MARS) and all dimensions.ConclusionsElderly and younger patients with rheumatic diseases have different demographic and clinical characteristics. Physical function and quality of life are more affected by rheumatic diseases and treatment adherence is poorer in the elderly. Our study found a positive correlation between physical function and quality of life in both age groups. The treatment adherence rating scale showed a negative correlation with physical function and quality of life scores, with individuals with poor treatment adherence having worse physical function and quality of life.

Adherence to Medical Treatment in Elderly Patients with Coronary Artery Disease in the Settings of Primary Outpatient Care

Aim. To study medication adherence in elderly patients with coronary artery disease (CAD) in primary care practice.Material and methods. The study conducted in out-patient clinic of Moscow city. 293 elderly (≥65 years) patients with established CAD included. The following patient data obtained via electronic medical record system: demography, medical history, modifiable risk factors and prescribed pharmacotherapy. Level of medication adherence measured by Morisky scale (MMAS-8) via telephone survey.Results. According to Morisky scale high adherence was identified in 146 (49.8%) elderly patients, moderate adherence – in 99 (33.8%) patients, low adherence – in 48 (16.4%) patients. Analysis of specific questions of the scale done in non-adherent patients revealed signs of unintentional non-adherence due to forgetfulness (45.9%) and signs of intentional non-adherence due to patients feeling worse (35.8%) or better (28.4%). By means of dichotomic interpretation of Morisky scale results the population under research was divided into two groups: 147 (50.2%) non-adherent patients and 146 (49.8%) – totally adherent patients. These groups were comparable in terms of sex (female 71.2 vs 68.0%; p&gt;0.05) and age (median 73.5 vs 73.0 years; p&gt;0.05) distribution, and medical history: myocardial infarction (39.0% vs 38.8%), atrial fibrillation (37.0 and 41.5%), chronic heart failure (90.4% vs 91.2%), diabetes (26.7% vs 24.5%). There were fewer smokers in adherent group (0.7% vs 6.5%; p&lt;0.05). As primary antianginal pharmacotherapy adherent and non-adherent patients were equally prescribed beta-blockers (75.3% vs 75.5%; p&gt;0.05). Drugs that improve prognosis were also prescribed comparably: antiplatelets (66.4% vs 61.9%; p&gt;0.05), anticoagulants (36.3% vs 44.9%; p&gt;0.05), statins (82.2% vs 79.6%; p&gt;0.05), renin-angiotensin system inhibitors (89.0 and 87.8%; p&gt;0.05). Adherent patients had lower mean values of lipids: total cholesterol (4.7±1.2 vs 5.2±1.4 mmol/l; p&lt;0.05) and low density cholesterol (2.4±0.9 vs 2.8±1.2 mmol/l; p&lt;0.05). Non-adherent elderly patients made more visits to general practitioner (median 5 vs 3 visits; p&lt;0.05). Share of patients receiving drugs within supplementary pharmaceutical provision program was comparable in both groups (53.7% vs 50.7%; p&gt;0.05).Conclusion. Half of elderly patients with CAD are non-adherent to treatment in primary care setting. Medical history and structure of pharmacotherapy do not influence level of adherence in this population. Among adherent patients fewer individuals smoke and mean values of lipids are lower. Non-adherent elderly patients cause higher load on general practitioner, supplementary pharmaceutical provision program provided no better adherence in the population under research.

Effects of Pharmaceutical Pictograms on Medication Adherence in Elderly Patients with Chronic Diseases at Primary Health Care Center in Hat Yai, Songkhla

Objective: To compare drug adherence with or without pharmaceutical pictograms in the elderly with chronic diseases. Materials and Methods: The present study was a randomized controlled trial conducted between April 2019 and June 2019 at a primary health care center in Hat Yai, Songkhla, Thailand. The elderly patients with chronic diseases were randomly allocated to the experimental group (n=25) and the control group (n=25). The experimental group received pictogram labels, text labels, and verbal information on the consumption of medications from the pharmacist. The control group received text labels and verbal information from the pharmacist. Both groups received follow-up home visits two weeks later. Results: The present study results showed that medication adherence using pill counts in the experimental group was significantly higher than in the control group. The median medication adherence scores from pill counts was (interquartile range, IQR) 100 (100, 100) versus 95.56 (90.25, 100), respectively, p=0.011. The medication adherence with the medication taking behavior measure for Thai patients (MTB-Thai) significantly increased in the experimental group (100.0%) compared with the control group (45.8%) (p=0.0002). Conclusion: The present study showed that medication adherence is greatly improved when the medication instruction is supplemented with pictograms. Therefore, medication should include pictograms on labels to better convey medical instructions to elderly patients with chronic diseases. Keywords: Pharmaceutical pictograms, Medication adherence, Chronic disease, Elderly patients

Association between Depression and Barriers to Medication Adherence in Elderly Patients With Diabetes

Association between Depression and Barriers to Medication Adherence in Elderly Patients With Diabetes

HUBUNGAN DUKUNGAN KELUARGA DENGAN KEPATUHAN MINUM OBAT PADA LANSIA PENDERITA HIPERTENSI

Background: Family support a trait that supportive and always provides help and assistance if needed by one of the family members. Form of family support in the form of information, assessment, instrumental, and emotional. According to records from the Health Profile of Central Java in 2017, the number of patients with hypertension was 8355 people. Family support also affects the occurrence of medication adherence in patients with hypertension. The purpose of this study was to determine the relationship of family support with medication adherence in elderly people with hypertension in the Gayamsari Community Health Center in Semarang.Research Methodology: This study uses quantitative research with a descriptive correlation method with a cross sectional approach and research instruments using questionnaires. The sample technique used Purposive Sampling Technique. The population 210 elderly and the sample 137 elderly. Analysis of the data used is the Spearman Rank test.Results: The results of this study were obtained from 62 elderly respondents with good family support, 46 (33,6%) had high medication adherence and 15 elderly received less family support, 15 (10,9%) had moderate medication adherence . Spearman Rho statistical test results showed that ρ value 0,000 ≤α 0,05. Correlation coefficient 0,874 which means there is a relationship of family support with medication adherence in elderly people with hypertension in the Gayamsari Community Health Center in Semarang city very strong.Conclusion: There is a relationship of family support with medication adherence in elderly patients with hypertension in the Gayamsari Community Health Center in Semarang.

Health-related quality of life and medication adherence in elderly patients with epilepsy.

Considering the high prevalence of epilepsy in the elderly and the importance of maximising their quality of life (QoL), this study aimed to investigate the relationship between medication adherence and QoL, and the mediating effects of medication adherence on the association between serum antiepileptic drug (AED) level and seizure severity with QoL in elderly epileptics. In a longitudinal study, 766 elderly patients with epilepsy who were prescribed a minimum of one antiepileptic drug were selected by convenience sampling method. A Medication Adherence Report Scale (MARS-5) questionnaire was completed at the baseline. Seizure severity and QoL were assessed after six months using the Liverpool Seizure Severity Scale (LSSS) and the QoL in Epilepsy (QOLIE-31) questionnaires respectively. Serum level of AED was also measured at six-month follow-up. Medication adherence was significantly correlated with both seizure severity (β = -0.33, p < 0.0001) and serum AED level (β = 0.29, p < 0.0001) after adjusting for demographic and clinical characteristics. Neither QoL nor its sub-classes were correlated with seizure severity. In addition, a significant correlation was not observed between serum AED level and QoL. However, medication adherence was significantly correlated with QoL (β = 0.30, p < 0.0001). The mediating effects of medication adherence on the association between serum AED level (Z = 3.39, p < 0.001) and seizure severity (Z = -3.47, p < 0.001) with QoL were supported by the Sobel test. This study demonstrates that medication adherence has a beneficial impact on QoL in elderly epileptics. Therefore, adherence to treatment should be monitored to improve their QoL.

Effect of an Educational Program based on Health Belief Model on Medication Adherence in Elderly Patients with Hypertension

Background: Aging population growth is accompanied by the risk of cardiovascular diseases and hypertension. Medication nonadherence is one of the problems affecting patients, especially elderly individuals with high blood pressure. Aim: The present study aimed to determine the effect of an educational program based on the Health Belief Model (HBM) on medication adherence in older adults suffering from hypertension. Methods: This randomized controlled clinical trial was conducted on 60-year-old elderly people referring to health centers in Mashhad, Iran, during 2017. To this end, the intervention group received education on medication adherence while the control group was only subjected to typical routine services. The data were analyzed in SPSS Software (Version 20) through the independent t-test, Chi-square test, and Fisher’s exact test. Results: The mean ages of the participants in the intervention and control groups were 69.1±8.3 and 63.9±6.7 years, respectively. The post-test mean score of medication adherence obtained by the intervention group was 6.7±0.5 that was significantly higher than that of the control group (3.7±1.0) (P˂0.001). Moreover, the mean score of medication adherence in the intervention group had significantly increased in the post-test phase (P˂0.001) based on the within-group results of the paired t-test. Implications for Practice: The HBM might improve medication adherence in elderly individuals with hypertension by changing their beliefs. Therefore, it was recommended to use this model for teaching self-care to older adults suffering from chronic illnesses and also in other senior healthcare centers.

Medication regimen complexity and medication adherence in elderly patients with chronic kidney disease.

Elderly patients with chronic kidney disease (CKD) stage 5 with or without dialysis treatment usually have concomitant comorbidities, which often result in multiple pharmacological therapies. This study aimed to identify factors associated with medication complexity and medication adherence, as well as the association between medication complexity and medication adherence, in elderly patients with CKD. This prospective study involved elderly patients with CKD stage 5 (estimated glomerular filtration rate < 15 ml/min/1.73m2 ) recruited from three Norwegian hospitals. Most of the patients were receiving either hemodialysis or peritoneal dialysis. We used the Medication Regimen Complexity Index (MRCI) to assess the complexity of medication regimens, and the eight-item Morisky Medication Adherence Scale (MMAS-8) to assess medication adherence. Factors associated with the MRCI and MMAS-8 score were determined using either multivariable linear or ordinal logistic regression analysis. In total, 157 patients aged 76 ± 7.2 years (mean ± SD) were included in the analysis. Their overall MRCI score was 22.8 ± 7.7. In multivariable linear regression analyses, female sex (P = 0.044), Charlson Comorbidity Index of 4 or 5 (P = 0.029) and using several categories of phosphate binders (P < 0.001 to 0.04) were associated with the MRCI. Moderate or high adherence (MMAS-8 score ≥ 6) was demonstrated by 83% of the patients. The multivariable logistic regression analyses found no association of medication complexity, age or other variables with medication adherence as assessed using the MMAS-8. Female sex, comorbidity and use of phosphate binders were associated with more-complex medication regimens in this population. No association was found between medication regimen complexity, phosphate binders or age and medication adherence. These findings are based on a homogeneous elderly group, and so future studies should test if they can be generalized to patients of all ages with CKD.

Determinants of Medication Adherence Among Iranian Elderly Patients with Chronic Diseases

Background: One of the most important problems of the elderly with chronic diseases is lack of medication adherence that imposes huge costs on every country health care system. Objectives: The aim of present study was to examine effective determinants on medication adherence in elderly patients with chronic diseases. Methods: A cross-sectional survey was conducted at two teaching hospitals in Qom, Iran, in 2016. A total of 100 patients aged 60 and older were selected by convenience sampling. Data collection tools were three questionnaires such as Morisky medication adherence scale (MMAS-8), brief illness perception questionnaire (B-IPQ), hospital anxiety, and depression scale (HADS). Multiple logistic regression analysis was performed for statistical assessment. Results: The mean and standard deviation age of the patients was 65.4 ± 5.2. More than two-thirds of the patients (71.4%) had poor medication adherence. In addition, among the variables entered into the multiple logistic regression model with P < 0.15 only Identify had a positive significant relationship with medication adherence (OR = 1.52, P = 0.010). Conclusions: Medication adherence in elderly patients with chronic diseases was poor and illness perceptions were effective in medication adherence in elderly with chronic diseases.

Effects of cognitive-behavioral group psychotherapy on depression, anxiety and medication adherence in aged patients with coronary heart disease

Objective To assess the effects of cognitive-behavioral group psychotherapy on depression, anxiety and medication adherence in elderly patients with coronary heart disease. Methods Eighty patients from two communities in Qinghai province were randomly divided into intervention group (n=40) and control group (n=40). In addition to regular care for both groups, patients in the intervention group also received cognitive-behavioral group psychotherapy.Depression, anxiety and medication adherence were measured with the Zung Self-Rating Depression Scale (SDS), the Zung Self-Rating Anxiety Scale (SAS) and the eight-item Morisky Medication Adherence Scale (MMAS-8), respectively, at baseline, immediately after intervention, at 3 months after intervention, and at 6 months after intervention. Results The repeated-measures ANOVA showed that improvement in depression, anxiety and medication adherence before and after intervention in the intervention group was greater than in the control group (F=22.805, 48.058, 128.058, all P<0.05). Scores for depression and anxiety were lower and scores for medication adherence were higher (all P<0.05) in the intervention group than in the control group at all the time points after intervention. Conclusions Cognitive-behavioral group psychotherapy can alleviate depression and anxiety, and improve medication adherence in elderly patients with coronary heart disease. Key words: Coronary disease; Depression; Anxiety; Medication adherence

Psychometric Properties of the Simplified Chinese Version of the Malaysian Medication Adherence Scale (C-MALMAS) on Elderly Patients

Summary Background Poor medication adherence is a concern among elderly patients. One of the convenient measures of medication adherence is by using a validated instrument. Therefore, this study aimed to examine the psychometric properties of the Simplified Chinese version of the Malaysian Medication Adherence Scale (C-MALMAS) for assessing medication adherence of elderly patients. Methods The C-MALMAS consists of 8 items which measure one domain. It was translated into the Simplified Chinese version and validated on a convenience sample of 100 elderly outpatients in Malaysia. Internal consistency of the C-MALMAS was evaluated based on Cronbach's alpha value. A retest was conducted a month later to assess its stable reliability. Validity was assessed using convergent validity by comparing C-MALMAS to the Simplified Chinese translation of the 8-item Morisky Medication Adherence Scale (MMAS-8) and concurrent validity was confirmed by comparing the medication adherence determined using C-MALMAS with that using pill count. Results The C-MALMAS has an acceptable internal consistency, with Cronbach's alpha of 0.586 and a test-retest correlation of 0.405 (p Conclusion C-MALMAS is a reliable and valid instrument for measuring medication adherence of elderly patients, especially when a specific recall period is required.

Medication knowledge as a determinant of medication adherence in geriatric patients, Serse Elian City, Menoufia Governorate, Egypt

Background Adherence to therapies is the corner stone of treatment success. Medication nonadherence in geriatric patients leads to substantial worsening of disease, increased healthcare costs, and death. Knowledge about the drug's indication, side effects, and interactions with other drugs may constitute a barrier to drug adherence. Objective The aim of this study was to assess the effect of medication knowledge as a determinant factor of medication adherence in elderly patients living in their own houses. Participants and methods This is a cross-sectional study of a random sample of 438 geriatric patients aged 70–85 years, living in their own homes in Serse Elian City, Menoufia Governorate. Patients' information was collected from the prescriptions in the file of the patient and home visits were carried out to examine their daily drug consumption. Results Male geriatric patients were found to be more adherent to their medications than female patients (63.9 vs. 36.1%). Correct knowledge regarding the name of the drug, it's timing, the correct dose, and indications constituted a statistically significant difference among adherent and nonadherent groups, whereas awareness about side effects of the drug did not have a significant effect on medication adherence. Conclusion Knowledge about medication in general constituted a significant determinant of medication adherence in elderly patients.

Medication Adherence of Elderly Patients With Chronic Heart Failure

The review is devoted to the problem of medication adherence in elderly patients with chronic heart failure. We consider here specificity of approach to management of elderly outpatients, groups of factors associated with medication adherence, and possible ways to improvement of compliance to treatment in patients from the senior age group with heart failure.