Objective: : Medication adherence is increasingly recognized as an important issue in treatment. Evidence shows that patients often do not take medication as prescribed. This may lead to poor clinical outcomes and risk inaccurate dosing as prescribers change doses as a reaction to perceived lack of effectiveness. Elderly patients, especially those with memory disorders, may be at risk for poor medication adherence. Our previous research had shown significant differences between patient and caregiver reports of medication adherence and supported the utility of an integrative model in understanding medication adherence in the elderly. In our earlier study, patients and caregivers reported lower levels of adherence to medications for the treatment of psychiatric conditions when compared to other medical conditions. The purpose of this study was to investigate these issues in a new group of patients and to replicate our earlier findings.
Design: Descriptive study of factors associated with patient and caregiver reports of medication adherence.
Materials and Methods: A new group of 25 patients and their caregivers at a university-affiliated memory disorders clinic were interviewed as part of routine clinical evaluation to assess levels of medication adherence. Additional data on patients’ level of cognitive function and mood were assessed as well. Data were analyzed to evaluate potential differences between patient and caregiver report of medication adherence and to assess differences in perceived seriousness between medical and psychiatric conditions
Results: Results of this study were consistent with previous findings in showing that caregivers’ and patients’ reports of adherence were different, with caregivers reporting lower levels of adherence than patients. Psychiatric conditions, including depression and psychosis, were rated as less serious than other medical conditions. Patients reported lower levels of adherence to these medications as well.
Conclusion:Results of this study in a new group of patients confirm previous results that show that patient and caregiver reports of medication adherence may diverge, with caregivers reporting lower and perhaps more realistic levels of medication adherence. Patients and caregivers report viewing psychiatric conditions as less serious than other conditions, and ratings of seriousness have been related to levels of adherence. These findings have important implications for clinicians treating the elderly.
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