Correlates of strategy use in medication adherence among older adults.

摘要

Approximately 50% of all medications are taken by older adults, with 34% of older adults taking three or more medications on a daily basis. Nonadherence and errors in self-administration of medications among older adults are common and have been reported as high as 43% of prescribed medication regimen. Medication adherence can be a complex cognitive behavior for older adults who are also experiencing age-related declines in cognitive functioning. Research shows that older adults use memory strategies as a compensatory mechanism for coping with age-related memory loss. Internal strategies involve mental activities to improve the quality of encoding or the search for previously encoded information, while external strategies involve the use of physical changes in the environment.; This research investigated the influence of health status, social support, memory self-efficacy, and depression on strategy use in medication adherence among older adults. Three hundred-forty one community dwelling older adults taking at least one prescription medication were administered a Medication Taking questionnaire that incorporated the Medical Outcomes Study Short Form (SF-36) and the 15-item Geriatric Depression Scale.; Older adults reported greater use of internal strategies than external strategies in remembering to take medications. Placing medications in a familiar place and concentrating hard when initially receiving the medications were the most frequently used external and internal strategies by older adults. Strategy use was positively correlated with health status and the number of medications taken. Social support was correlated with external strategy use, but not with internal strategy use. Memory self-efficacy was not correlated with external and internal strategy use. Contrary to expectations, depression was associated with greater use of internal strategies. Older adults preferred event-based over time-based prescription medication instructions. Health status, number of medications, and depression were significant predicators of internal strategy use, while health status and number of medications taken were significant predictors of external strategy use. Age, memory self-efficacy, and depression were significant predictors of medication adherence. These findings have implications for cognitive theory, healthcare practice and policy, and future aging research.