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LETTER TO EDITOR
J Edu Health Promot 2018,  7:108

A comment on medication adherence in geriatric patients: A reply to Abarazi et al. (2017)


Department of Community Medicine, Maulana Azad Medical College, New Delhi, India

Date of Web Publication10-Jan-2018

Correspondence Address:
Dr. Saurav Basu
Department of Community Medicine, Maulana Azad Medical College, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jehp.jehp_4_18

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How to cite this article:
Basu S. A comment on medication adherence in geriatric patients: A reply to Abarazi et al. (2017). J Edu Health Promot 2018;7:108

How to cite this URL:
Basu S. A comment on medication adherence in geriatric patients: A reply to Abarazi et al. (2017). J Edu Health Promot [serial online] 2018 [cited 2018 Aug 22];7:108. Available from: http://www.jehp.net/text.asp?2018/7/1/108/238366

Sir,

The article by Abazari et al. (2017) reports the adherence to drug therapy in older geriatric populations in Iran.[1] The study generates important evidence regarding medication adherence in the geriatric population which is particularly at risk of developing noncommunicable diseases However, there is a methodological concern regarding the study which is discussed below.

The geriatric population could suffer from several disease conditions such as diabetes, hypertension, chronic obstructive pulmonary disease, lipid disorders, and osteoporosis which require drug administration for durations extending till the end of life. Several comorbid conditions are often found in geriatric patients. The Abarazi (2017) study evaluated self-reported medication adherence jointly for all these distinct medical conditions although the 8-item Morisky Medication Adherence Scale-8 is validated only for individual disease conditions such as hypertension and diabetes.[2],[3] The Abarazi (2017) study, therefore, is unable to distinguish between the extent of medication adherence in a condition like diabetes from that of another like hypertension. Furthermore, the authors could have also explored the association of comorbidity with medication adherence. This is because comorbidity, like the presence of both diabetes and hypertension in the same subject, can impede medication adherence due to factors like increasing regimen complexity.[4] Furthermore, the high pill burden could deter adherence as patients may perceive the risk of adverse effects from taking too many medications.[5] Patient adherence to different disease conditions can also be influenced by their perceived susceptibility to the disease complications which can vary for different diseases as per the Health Belief Model.

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Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Abazari P, Jafari TA, Sabzghabaee AM. How much elderly people of Isfahan are adherent to their drug therapy regimens? J Educ Health Promot 2017;6:12.  Back to cited text no. 1
    
2.
Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich) 2008;10:348-54.  Back to cited text no. 2
    
3.
Al-Qazaz HK, Hassali MA, Shafie AA, Sulaiman SA, Sundram S, Morisky DE, et al. The eight-item Morisky medication adherence scale MMAS: Translation and validation of the Malaysian version. Diabetes Res Clin Pract 2010;90:216-21.  Back to cited text no. 3
    
4.
Odegard PS, Gray SL. Barriers to medication adherence in poorly controlled diabetes mellitus. Diabetes Educ 2008;34:692-7.  Back to cited text no. 4
    
5.
Kilonzo SB, Gunda DW, Bakshi FA, Kalokola F, Mayala HA, Dadi H, et al. Control of hypertension among diabetic patients in a referral hospital in Tanzania: A Cross-sectional study. Ethiop J Health Sci 2017;27:473-80.  Back to cited text no. 5
    




 

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