%0 Journal Article
%T Adherence to Medications after Hospital Discharge in the Elderly
%A Elie Mulhem
%A David Lick
%A Jobin Varughese
%A Eithne Barton
%A Trevor Ripley
%A Joanna Haveman
%J International Journal of Family Medicine
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/901845
%X Objectives. To evaluate the adherence rate to prescribed medications in elderly patients 24¨C48 hours after being discharged from the hospital. Methods. Family medicine residents visited patients over the age of 65 years at their homes one to two days after being discharged from the hospital and documented all the medications that they were taking since coming home from the hospital. The list of medications was later compared to the medications recorded in hospital discharge instructions. Results. Complete data was available for 46 participants. The average patient age was 76 years; 54.4% were women. Only three patients (6.5%) adhered completely to the discharge medication list found in the medical record. Thirty-six patients (78.2%) reported taking at least one additional prescription medication, twenty patients (43.4%) missed at least one prescription medication, twenty patients (43.4%) reported taking the wrong dose of at least one medication, and nineteen patients (41.3%) reported taking medications at an incorrect frequency. Conclusion. The vast majority of elderly patients in our study did not adhere to the medication regimen in the first two days after hospital discharge. Cost-effective improvements to hospital discharge processes are needed to improve adherence and reduce preventable posthospitalization complications. 1. Introduction The elderly are at a significant risk for medication-related problems, including nonadherence, especially at times of transition in and out of the health care system. Many factors contribute to the risk of nonadherence in older patients including a higher prevalence of chronic diseases, a higher number of prescription and nonprescription medications compared to any other age group, and age-related physical and mental capabilities that also may pose a challenge to their ability to adhere to prescribed medications regimens [1]. It is well known that nonadherence to medications can result in worsening clinical outcomes, including rehospitalization, exacerbation of chronic medical conditions, increased healthcare costs, and death [2¨C4]. Robin Dimatteo et al. reported that the odds of poor health outcomes are nearly three times higher for patients who do not adhere to recommended therapies compared to patients who follow providers instructions [2]. The transition from hospital to home is a particularly vulnerable time for elderly patients, and nonadherence to prescribed medication regimen after discharge from the hospital increases the risk of postdischarge complications. Forster et al. reported that one in five
%U http://www.hindawi.com/journals/ijfm/2013/901845/