De Williams, J. and Enubuzor, H.
Department of Family Practice and Community Medicine, SVCMC
Presented at the BWAFP Research Forum 2001

While patients over the age of 65 account for 12% of the general population, they use 30% of prescription medications.  Ambulatory elderly patients take an average of 7.9 drugs per person per day.  In light of these statistics, it is not surprising that there are difficulties with medication compliance, either by overuse (related to forgetfulness or attempts to speed recovery) or underuse (the most common type of non-compliance) which can be linked with memory deficits, drug side effects, or costs.

A confidential survey consisting of 18 questions was conducted for two weeks at the Theodora Jackson Senior Center in Jamaica, Queens. It assessed different factors influencing compliance in following prescribed medications. The participants consisted of men and women older than 65 years old, mainly Hispanics and blacks. Eighty-one survey forms (51 women, 30 men) were compiled and analyzed. Ages ranged from 65 to 83.

The result of this study revealed that the main barriers to medication compliance are: polypharmacy, drug side-effects, cost of medication, lack of proper information, cognitive disfunction (memory deficit is the most common cause of  inappropriate use), and functional disabilities (such as impaired hearing or vision). Several factors interfere with achieving the goal of good compliance when talking about the elderly population. Poor compliance results in inadequate or incomplete treatment, prolonging the course of the disease and the length of therapy, resulting in increasing cost and consequently decreasing compliance. The approach has to be multi-faceted. Multiple strategies are needed to improve medication compliance in elderly patients. Among them are: holding seminars with medical professionals emphasizing clear information, including written instructions to the patients, establishing clear treatment goals, eliminating polypharmacy and simplify dosing regimens, considering the financial resources of the patient, and assisting the patient in organizing a system for taking medications.