Drug noncompliance in the elderly

Drug noncompliance is a major therapeutic problem for clinicians who deal with the elderly. This group receives 25% of all prescriptions, although comprising only 11% of the population. Clinicians overestimate their patients' compliance by 100%. One-third of patients always comply, one-third sometimes comply, and one-third never comply. Noncompliance can be determined by pill counts, timing of refills, blood and urine drug levels, and observation of therapeutic effect. Contributing factors to noncompliance include vision, hearing, and memory impairment, side effects, drug interactions, fear of drug dependency, difficulty in obtaining of taking medication, complicated regimens, and lack of confidence in the clinician. Recommendations are given to aid the clinician in overcoming noncompliance. The elderly benefit from verbal instructions reinforced in writing, frequent visits, simplified regimens, clearly labeled, non-childproof containers, and involvement of family members. An illustrative case study is presented.