Medication adherence and knowledge in older patients

To assess the degree to which a sample of older individuals - who are engaged with psychiatric services - are knowledgeable about their medication and the reason for its prescription; to assess the degree to which these patients adhere to what is prescribed.

Convenience sample of 24 patients over 65 years old, under the care of psychiatric services for Later Life, included. Patients who scored < 23 on Mini-mental State Examination were excluded. A questionnaire was administered which evaluated patients' knowledge of the names of, and reasons for, all prescription medications. Adherence rates were measured. Comparisons were made regarding to self-reported adherence rates and medication knowledge. These were based on diagnosis, age, number of medications prescribed and the presence or absence of sensory impairment.

The median percentage of medication names recalled was 60%. A total of 25% of patients reported having some problem with adherence. No patient with a diagnosis of dementia was able to recall the names of, or reasons for, all medications prescribed. Patients with depression and dementia were as likely to be fully adherent as the total sample. Patients (a) aged 78 years or more and (b) those who were on more than six medications - were less knowledgeable about and less likely to adhere to prescribed drug regimens. We did not identify an association between reduced visual acuity and reduced medication adherence Conclusion: Patients require ongoing education concerning all aspects of medication, especially the reasons for prescription. Older patients and those receiving more complex regimens may be at particular risk of adherence problems.