Abstract and Keywords
Adherence to medication is an intriguing and complex behavior. It is a multifaceted construct that is influenced by a range of factors. The problem of nonadherence remains a challenge for health-care professionals and patients. In the literature, age has been inconsistently associated with poor adherence, and there is no strong evidence that it is more prevalent in the older population. However, older age presents a multitude of potential risk factors for nonadherence, which may result in poor health outcomes, lower quality of life, and increased health-care costs. Many studies investigating adherence are limited by a lack of commonality in terms of how adherence is measured, the definition of an older person, and the range of disease states that have been examined. To date, efforts to explain and improve patient adherence have been disappointing and ineffective. Various strategies have been proposed; however, most evidence appears to advocate interventions that include components of a medication review with the aim of simplifying the drug regimen. Once-daily scheduling of drug administration may offer a pragmatic approach to optimizing drug therapy in some conditions. The use of fixed-dose combinations and forgiving drugs (which have a prescribed dosage interval that is 50% or less the duration of drug action) have also been proposed. Optimal adherence should be viewed as a means of achieving a satisfactory therapeutic outcome and not as an end in itself.
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