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Medication Adherence in Older Adults is Not So Simple

Medication adherence, defined as the degree to which a person follows medication instructions, is a challenge for older adults. Indeed, it is estimated that about 50% of older adults are not fully adherent with their medications. The reasons are multifold, however, and not simply a matter of remembering to take a pill. Poor medication adherence among adults age 65 and older results from complex drug regimens plus numerous individual variables.

For an older adult, the challenge of medication adherence is impacted by having to manage refills for five, ten, or even 15 medications; from additive drug costs; and from having to take medications at multiple times throughout the day. It is impacted by drug side effects, not knowing the reason for each medication, individual beliefs surrounding the value of medications, physician-patient relationships, as well as many other patient-specific factors, such as the nature of the chronic illness (dementia, for example, or treating a condition like high cholesterol that has no symptoms) or a person’s ability to read the prescription labels.

Medication adherence cannot be automated. Above are just a few examples of why this topic is so complex, and as such, why there is no one simple solution for older patients. Use of unnecessary and potentially inappropriate medications in older adults is an epidemic in America. Medication adherence can be improved by simplifying drug regimens and ensuring patients take only what they truly need. Identifying and correcting medication-related problems requires the expertise of a geriatric-trained healthcare professional who can evaluate the risks and benefits of medication use in an aging patient.

Written by Hedva Barenholtz Levy, PharmD, BCPS, BCGP

April 28, 2021

This material is intended to encourage discussion with your health care provider.  It is informational only and not intended to replace the guidance of your health care team.