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02/12/2014

Medication Adherence: Does it Change as You Age?

Medication adherence is the extent to which a patient accurately follows the prescribed medication timing, dosage and frequency. Many factors influence medication adherence such as a patient’s age, social background, healthcare coverage, and even type of illness. The following series of blogs will focus on the effect of medication adherence on varying age groups, such as children, adolescents and adults.

Children: Matsui states that in the pediatric population, the adherence rate ranges from 11% to 93% with a median of 58%. It is evident that just over half of the pediatric population is properly using their prescribed medication. Children are dependent on their family to help manage their disease. Barriers such as insufficient understanding of medication use and drug administration techniques may also play a role in decreasing adherence. Therefore, many factors contribute to the overall success of medication adherence in children.

Adolescents: As children grow up to be adolescents, or teenagers, they become more independent in taking charge of their own health needs. In contrast to popular belief, the Matsui review article shows that the adherence level reaches a nadir during adolescent years. A barrier such as peer influence prevents teenagers from being compliant to certain regimens treating disease states of diabetes, renal disease, asthma and HIV.  Therefore, it is important to evaluate the support a young adult receives from peers, family and society. It is a critical point in time where children are becoming more independent and therefore will start to develop their own perception of the purpose of medication use.

Adults: Adults are usually the main focus when trying to improve medication adherence in a specific population. This is because there are multiple factors that have been known to influence this age group. Factors such as status of illness (acute versus chronic), insurance coverage, pill burden and disease understanding all help determine patient’s compliance to regimen. Cohen states that when looking at discharged patients there is a very small absolute increase of 1% in adherence for every 10 year increase in age. This shows that one cannot presume that there is a high improvement in medication adherence as patients grow older.

Looking at various age groups shows that the barriers to medication adherence are not identical. As health care providers, pharmacists are the most involved in patients’ medications and therefore should take the opportunity to discuss the importance of adherence. Tackling each age group’s specific barriers will allow pharmacists to assist the patients in overcoming the difficulties and improve overall medication adherence.

Sheenu Joseph, PharmD '15 Candidate

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