Behavior changing strategies may improve medical adherence

MU researchers identify changing behavior as the key to improving medical adherence

Taking medication as the doctor prescribes is crucial to improving health. However, 26 to 59 percent of older adults do not adhere to instructions, according to a 2003 study published in Drugs and Aging. In a new study, researchers at the University of Missouri found that applying behavior changing strategies, such as using pill boxes or reducing the number of daily doses, can improve patients' abilities to take their medications as required.

"It is very important for physicians and nurses to move past educating patients about the need for medication and focus on teaching behavior strategies," said Vicki Conn, associate dean of research and Potter-Brinton professor in the MU Sinclair School of Nursing. "Implementing these strategies can help older adults take their medications, resulting in better health and well-being."

The Mizzou researchers found that behavior-changing strategies have a greater impact on medication adherence than reinforcing the importance of taking medication to patients. Effective strategies include reducing the number of doses taken daily, prescribing medications so they can be taken at the same time as other medications, and encouraging the use of pill boxes. Giving patients clear, easy to read instructions for the medications also proved to be effective.

There are many reasons older adults have difficulties with medications, Conn said. Vision changes can interfere with reading medication bottles, and arthritis can make it difficult to handle pills and containers. However, the majority of adherence problems are not related to physical health. For example, many people simply forget to take their medications.

"There are approaches to overcome almost all problems," said David Mehr, co-author of the study and director of research in the MU Department of Family and Community Medicine. "It makes a huge difference in patients' adherence and health if they have some type of organized system for taking medication."

Failure to take prescribed medications can result in costly health interventions, including expensive tests and unnecessary additional prescriptions, Conn said. An interest in medication adherence research has grown recently due to its low rates among the adult population. In this study, the researchers conducted an analysis of 33 trials to combine and relate the findings of previous research.

The study "Interventions to Improve Medication Adherence Among Older Adults: Meta-Analysis of Adherence Outcomes Among Randomized Controlled Trials" was published in the August issue of The Gerontologist.

Source: University of Missouri-Columbia