As we age, medication adherence is one of the most complex and important topics. Nearly 90% of adults age 65 and older take at least one prescription medication, and more than 50% take four or more prescriptions, according to the Kaiser Family Foundation. The Department of Health and Human Services also reports that 55% of older adults are non-compliant with their prescription drug orders (meaning they do not take their medication according to the doctor's instructions).
Before we can identify ways to improve adherence, we have to investigate the reasons behind the non-compliance. Here we outline some of the most common factors that are affecting older adults’ ability (or choice) to take medications as prescribed.
Confusion and Complexity:
Approximately 80% of older adults have two or more chronic conditions like diabetes, arthritis, and/or heart disease. When managing multiple diagnoses, various specialists, and a pharmacy-worth of medications, it can be very easy to get confused.
Every prescription has a specific dosage, cadence to take it, instructions like taking with or without food or water, and so on. Plus, many pills look the same and could very plausibly get mixed up from time to time. When we consider that half of older adults are managing 4 or more medications, it’s no wonder non-compliance is so widespread… It's essentially a full-time job to keep track of everything!
Have you ever asked yourself, “did I feed the dog this morning?” or “did I remember to turn off the iron?” If so, you can imagine how easy it would be to either skip a dosage or take an extra from time to time. This can be tricky for both seniors that have a busy schedule and those that find themselves without much structure or engagement throughout the day.
Unfortunately many older adults also find the challenge compounded by cognitive decline and end up needing reminders, equipment, or caregiver support to take medications as prescribed.
You may take for granted how simple it is to open a prescription bottle and swallow a pill. However, anyone that faces arthritis or dysphagia will tell you that there are still serious barriers to the physical act of taking medication. While there may be substitutions to help individuals with limitations like this, they may find themselves embarrassed or unwilling to ask for the help they need.
Plain and simply, the cost of prescription medication is proven to negatively impact adherence. In fact, 23% of seniors skip dosages to make their supply last longer and 22% report that they have not filled prescriptions at least once in the past year due to the cost. Sadly, more than one in five older adults spends less on food, heat, or other necessities so they can afford to purchase their medications. When managing a fixed income, budgeting for expensive medications can be a major barrier.
Side Effects or Effect of Medication Itself:
Perhaps one of the most common reasons for non-compliance is either the real or perceived effects of the medication. This could refer to a number of things, including: unintended side effects, skepticism about the benefits, concerns about dependency, or even dislike of the medication’s effect in the first place.
All of these concerns are valid and understandable, but they also often result in patients skipping doses. It is so important to keep open lines of communication and nurture a safe space where seniors feel comfortable being honest about their experiences or worries.
Understanding the root of the reasoning behind non-compliance is the first step toward improving medication adherence.
While ElliQ enterprise partners have always had the ability to set and send medication reminders and messages to users through their Care Center Dashboard, they now have access to two new features. If a patient did not take their medication, ElliQ will ask them the reason, log their response, and send a notification to the care team. If they simply do not respond to a reminder that is listed as “critical medication,” a notification will be sent to through the Care Center as well. These important updates help paint a more accurate picture so that care teams and physicians can best support the older adults they support.
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