Medication Adherence in Elders - Essay Example

"Medication Adherence in Elders" is a decent example of a paper on care.
Studies investigating the prevalence of medication adherence have treated it as a single issue despite the large and diverse number of classifications of the problem proposed over the years. These classifications have been based on the causes of nonadherence and the degree of non-adherence (Unni, 2008). Another classification based on socioeconomic conditions identifies primary and secondary non-adherence (Wamala et al., 2007). The classifications based on causes have used a list that in itself is incomplete. Thus the typology used for the study of medication adherence has been varied and lacks precision. A study of prevalence demands a specific description and typology of the issue, in absence of which assessment and comparison of data becomes impossible and the study remains incomplete. Thus the primary goal of this research is to prepare an exhaustive list of causes of medication adherence based on the available literature to form a precise and completely descriptive typology of medication adherence.

Medication adherence in elderly patients is influenced by a multitude of reasons and its study requires a multidisciplinary approach. Issues ranging from psychiatric to socioeconomic, personal to professional, and mere carelessness to depression can be the cause of medication non-adherence. This extreme variability has rendered assessment of the prevalence of medication non-adherence complicated.  Neither are precise methods available nor is sufficient data to enable precise assessment. Thus utmost caution needs to be exercised in the selection of tools need for gathering relevant data. The long list of tools including self-report, pill count, electronic monitoring, etc has its own set of advantages and disadvantages rendering the selection process complicated. Electronic monitoring among these is the most frequently used assessment tool for medication non-adherence and has also been considered to be most accurate (Murray et al., 2005). Touted as ‘the gold standard’, MEMS (Medication Event Monitoring System) of the AARDEX group has been the preferred choice of many researchers. The system uses an electronic monitoring strategy for gathering data on dosage taken by the patients. The system integrates the drug packets with a microcircuit which records events involving the opening of packages and removal of medication (AARDEX). However, despite its accuracy, the device has several limitations as well. A bottle opened by mistake, or a tablet removed but accidentally or deliberately not used, or multiple dosages removed simultaneously for convenience may lead to a wrong recording and facilitate misleading data (Farmer, 2010).

In order to provide additional data support, another method needs to be used in conjunction with electronic monitoring. Pill count has been reported to superior method compared to refill history and twenty-four-hour recall and is also a suitable method for clinical studies. Compared to the remaining two, pill count is less affected by time gaps (Lee et al., 2007) and hence can be considered as a suitable secondary tool besides the primary tool of electronic monitoring. Further substantiation through questionnaires can add to the authenticity and credibility of the data, and also facilitate an understanding of the causes of non-adherence.