Adherence to the therapeutic medication and biopsychosocial aspects of elderly integrated in the home-based long-term care

Monterroso, Lígia Eduarda Pereira; Sá, Luís Octávio de; Joaquim, Natércia Maria Teixeira

doi:10.1590/1983-1447.2017.03.56234

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Original Article • Rev. Gaúcha Enferm. (Online) 38 (3) • 2017 • https://doi.org/10.1590/1983-1447.2017.03.56234 linkcopy

Adherence to the therapeutic medication and biopsychosocial aspects of elderly integrated in the home-based long-term care

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective To evaluate the association between the biopsychosocial aspects and the adherence to the therapeutic medication of elderly integrated into the home-based long-term care teams.

Methods A cross-sectional, quantitative study, with a sample of 198 eldery. Interviews took place between May 2012 and May 2013 in Portugal. For therapeutic characterization, the data were collected using two questionnaires and one interview. Data analysis made with the Statistical Package for Social Sciences version 20.0. Descriptive statistics were used to present the results and the Chi-Square test to evaluate the association between variables.

Results It was observed that 49% of the elderly do not adhere to the therapeutic medication and the level of adherence showed a statistically significant association with nutritional status (p = 0.002), instrumental autonomy (p = 0.030) and social isolation (p = 0.046).

Conclusions Due to the multiplicity of aspects involved in adherence, it is suggested that they be considered in the nursing interventions that promote therapeutic control measures.

Medication adherence; Elderly; Home health nursing

Measure of Adherence to the Treatment – Questions	Likert scale (Measure of Adherence to the Treatment)

	Average	Standard deviation
Have you ever forgotten	5.00	0.95
Neglected the correct time	4.89	0.95
Felt better and abandoned the medication	5.31	0.90
Felt worse and abandoned the medication	5.23	0.97
More tablets	5.42	0.81
Did not have the medication at home	5.19	0.858
Abandoned for other reasons	5.47	0.74
TMRA index	5.22	0.66

Biopsychosocial Assessment Method	(Measure of Treatment Adherence)		χ2(p)
Biopsychosocial Assessment Method	Does not Adhere N (%)	Adheres N (%)	χ2(p)
Psychological Area
Emotional Complaints
Unfavorable	55 (56.7)	50 (49.5)	0.310
Favorable	42 (43.3)	51 (50.5)	0.310
Cognitive State
Unfavorable	19 (19.6)	28 (27.7)	0.179
Favorable	76 (80.4)	73 (72.3)	0.179
Social Area
Social Isolation
Unfavorable	41 (42.3)	29 (28.7)	0.046
Favorable	56 (57.7)	72 (71.3)	0.046
Habits
Unfavorable	65 (67.0)	59 (58.4)	0.211
Favorable	32 (33.0)	42 (41.6)	0.211

Therapeutic Pharmacological Profile	Therapeutic Regime Adherence		χ2(p)

	Does not Adhere	Adheres

	N (%)	N (%)
No. of Prescribed Medicines
Between 1 and 3	40 (41.2)	36 (35.6)
More than 3	57 (58.8)	65 (64.4)	(0.418)
Acquisition of Medicines Prescribed
Yes	87 (89.7)	98 (97.0)
No	10 (10.3)	3 (3.0)	(0.037)
Who acquires the medicine
The elderly themselves	9 (9.3)	25 (24.8)
Others	88 (90.7)	76 (75.2)	(0.005)

Biological Profile	Therapeutic Regime Adherence		χ2(p)

	Does not Adhere N (%)	Adheres N (%)
Gender
Male	33 (34.0)	38 (37.6)	0.597
Female	64 (66.0)	63 (62.4)
Age group
Elderly (≥ 65 and < 80 years)	39 (40.2)	49 (48.5)	0.240
High age elderly (> 80 years)	58 (59.8)	52 (51.5)
Health Complaints
Has complaints	87 (89.7)	99 (98.0)	0.014
Has no complaints	10 (10.3)	2 (2.0)
Nutritional State
Unfavorable	71 (73.2)	52 (51.5)	0.002
Favorable	26 (26.8)	49 (48.5)
Falls
Unfavorable	40 (41.2)	37 (36.6)	0.507
Favorable	57 (58.8)	64 (63.4)
Locomotion
Dependent	66 (68.0)	67 (66.3)	0.798
Independent	31 (32.0)	34 (33.7)
Physical Autonomy
Dependent	60 (61.9)	63 (62.4)	0.940
Independent	22 (38.1)	53 (37.6)
Instrumental Autonomy
Dependent	89 (91.8)	82 (81.2)	0.030
Independent	8 (8.2)	19 (18.8)

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[TFN1001] Source: Research data, 2013