• Korean Journal of Clinical Pharmacy
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• v.21 no.2
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• pp.81-89
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• 2011

Medication adherence is an important public health issue. This study is conducted to explore non-adherence of elderly with hypertension and/or diabetes mellitus and to better understand its' influencing factors. To explore non-adherence, 605 elderly patients in community were surveyed with Modified Morisky Scale (MMS), from Aug 18 to Sept 19, 2008. MMS is designed to predict medication-taking behavior and outcomes, and also to explain persistence of the patient's long-term continuation of therapy, which is a significant factor in the long-term management of chronic diseases. Also, MMS is designed to classify patients into a high/low continuum for knowledge and motivation. Patients self reported medication adherence were average 4.66 with MMS (range 0-6), only 78% of patients hold high motivation of medication adherence although 95.5% of patients hold high knowledge of medication adherence. This study explores which factors influence to high motivation of medication adherence and it proved that patients' participation in work, education level, participation in private health insurance, number of medication and medication frequency per day, pharmacists' explanation, experience of non adherence due to cost are important factors to explain high motivation of medication adherence of elderly with hypertension and/or diabetes mellitus.

• Genomics & Informatics
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• v.12 no.3
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• pp.121-126
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• 2014

Medication adherence is generally defined as the extent of voluntary cooperation of a patient in taking medicine as prescribed. Adherence to long-term treatment with chronic disease is essential for reducing disease comorbidity and mortality. However, medication non-adherence in chronic disease averages 50%. This study was conducted a genome-wide association study to identify the genetic basis of medication adherence. A total of 235 medication non-adherents and 1,067 medication adherents with hypertension or diabetes were used from the Korean Association Resource project data according to the self-reported treatment status of each chronic disease, respectively. We identified four single nucleotide polymorphisms with suggestive genome-wide association. The most significant single nucleotide polymorphism was rs6978712 (chromosome 7, $p=4.87{\times}10^{-7}$), which is located proximal to the GCC1 gene, which was previously implicated in decision-making capability in drug abusers. Two suggestive single nucleotide polymorphisms were in strong linkage disequilibrium ($r^2$ > 0.8) with rs6978712. Thus, in the aspect of decision-making in adherence behavior, the association between medication adherence and three loci proximal to the GCC1 gene seems worthy of further research. However, to overcome a few limitations in this study, defining the standardized phenotype criteria for self-reported adherence should be performed before replicating association studies.

• Journal of Korean Biological Nursing Science
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• v.19 no.1
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• pp.18-29
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• 2017

Purpose: This study investigates the status of medication use of the elderly with chronic disease taking non-opioid analgesics and attempts to identify factors influencing medication adherence. Methods: Data were collected from September 1 to October 19, 2016. A structured questionnaire was used for face-to-face interview with a convenience sample of 161, elderly people with chronic disease taking non-opioid analgesics. The survey included questions about status of medication use, medication adherence, symptom experience, depression and family function. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression with IBM SPSS 23.0 program. Results: The mean score of medication adherence of the elderly with chronic disease was $4.48{\pm}2.35$. Experiences of side effects (${\beta}=.31$, p< .001), use of over-the-counter pain medication (${\beta}=.19$, p= .009), and family function (${\beta}=.16$, p= .031) were identified as significant predictors. The final model explained 18.0% of the variation of medication adherence of the elderly with chronic disease taking non-opioid analgesics (F= 12.30, p< .001). Conclusion: Therefore, as a strategy to improve medication adherence of the elderly with chronic disease, therapeutic intervention should be developed to improve family function and to manage with personalized plans considering experiences of side effects and use of over-the-counter pain medication.

• The Journal of the Korea Contents Association
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• v.19 no.12
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• pp.398-406
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• 2019

This study was conducted to examine the medication non-adherence and related factors based on medication adherence model of older adults that use polypharmacy. A survey was used to collect data from 190 study participants. Among the 190 subjects, 43.2% did not adhere to their polypharmacy intentionally. The reason for medication non-adherence was listed in order of 'when they felt well on symptoms', 'when it was annoying and uncomfortable', and 'when they felt worse due to medication'. Moreover, the older adults often do not seek for medication information actively. Between adherence and non-adherence groups, while there were differences in gender, type of medication, and experience in drug-related side effects, there were no statistically significant differences in medication information contents and route. This study demonstrates that gender, type of medication, and experience in drug-related side effects should be considered to promote medication adherence. In addition, since the elderly with polypharmacy are rarely actively searching for the contents and route of drug information, the contents of drug information need to be provided by the route preferred by the elderly in order to assist in their decision-making process for polypharmacy.

• Korean Journal of Clinical Pharmacy
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• v.26 no.2
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• pp.128-136
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• 2016

Objective: This study was to explore the association between having a usual source of care and adherence to medicines in patient with chronic diseases. Methods: The 2012 Korea Health Panel was used as a data source. We analyzed 4,418 respondents that were diagnosed with chronic diseases and utilized health care services. Non-adherence to medication, a dependent variable, was defined as "not taking the medicines that were prescribed for treating chronic disease" or "not following the direction for medication". Whether having a usual source of care or not was used as a key independent variable, which was defined as having a regular site or a regular doctor for medical test, treatment, and consultation. Sex, age, education level, marital status, income, the type of health insurance, the number of chronic disease and CCI (Charlson Comorbidity Index) were included as covariates in the analysis. We conducted a multivariate logistic regression. Results: Totally, 30 percent of respondents reported to experience non-adherence to medication. Having a usual source of care was significantly associated with lower non-adherence to medication regardless its type, which is a regular doctor (OR=0.61, 95% CI=0.53-0.70) or a regular site (OR=0.67, 95% CI=0.58-0.78). Furthermore, having a usual source of care was associated with both of medication persistence (OR=0.66, 95% CI=0.54-0.81) and compliance (OR=0.65, 95% CI=0.56-0.76). Conclusion: Our results showed the possibility that usual source of care is able to conduct a positive role in improving adherence to medication with better management of chronic disease.

• Journal of Korean Society of Health-System Pharmacists
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• v.35 no.4
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• pp.418-429
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• 2018

Background : To improve medication adherence in elderly patients, the role of pharmacists in teambased services has been highlighted in the literature. However, not much is known about the role and the service elements involved in comprehensive geriatric programs in South Korea. This study was designed to describe the current status of medication adherence in geriatric patients based on the comprehensive geriatric assessment program and analyze the predictive factors for medication adherence in a tertiary teaching hospital. Methods : A retrospective cohort study was performed using electronic medical records of 247 patients from March 1st, 2015 to August 31st, 2015. Medication adherence and the types of non-adherence were also collected. Predictive factors for adherence were evaluated by including factors related to demographics, medications, illness, and patterns of medical usage. Results : The mean age of the study population was 81.2 years (range 65~98 years) and they were taking 9.7 drugs on an average (SD 5.0 drugs). The overall rate of non-adherence was 34%. About 48% of the patients had any forms of assistance in the medication administration. The most common type of non-adherence was "self-adjustment". The multivariate analyses revealed that age (adjusted odds ratio, 0.87 [95% CI, 0.80-0.96]; p 0.05) and the number of inappropriate medications (adjusted odds ratio, 0.59 [95% CI, 0.40-0.89]; p 0.05) were strong predictors for non-adherence. Conclusions : These results indicate that strategic considerations of the predictors of non-adherence should be improved in medication counseling services targeting elderly patients.

• Korean Journal of Clinical Pharmacy
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• v.33 no.4
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• pp.254-260
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• 2023

Background: Adherence to antiretroviral treatment (ART) is crucial for maintaining the HIV-RNA suppression in patients living with HIV/AIDS. This study aims to analyze the risk factors contributing to low medication adherence among individuals with HIV/AIDS by analyzing data from the Korean HIV/AIDS cohort study. Methods: The dependent variable is ART medication adherence. The depressive symptom and anxiety scores were collected as main independence variables. Covariates included gender, age, transmission route, alcohol and smoking information, and antiviral treatment regimen details. To predict the relationship between ordinal dependent variables and independent variables, an ordered logistic regression analysis was conducted, and odds ratios (OR) were calculated. Results: The results of the ordered logistic regression analysis showed that female was associated with a higher risk of low medication adherence (OR=2.91, 95% CI=1.08, 7.83). Among the subjects who were non-smokers and non-drinkers, the risk of low medication adherence was lower (OR=0.36, 95% CI=0.18, 0.70). Depending on the ART treatment group, individuals taking integrase inhibitor had a lower risk of medication adherence (OR=0.31, 95% CI=0.13, 0.76), and those experiencing depressive symptoms were related with a higher risk of low medication adherence (OR=1.97, 95% CI=1.12, 3.46). Conclusions: The encouragement and emotional support of healthcare professionals are essential for patients living with HIV/AIDS who experience depressive symptoms to maintain ART adherence. Additionally, further research is needed to ensure that HIV/AIDS infected female with concurrent depressive symptoms can achieve appropriate ART therapeutic effect.

• Korean Journal of Schizophrenia Research
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• v.23 no.2
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• pp.51-57
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• 2020

Treatment-resistant schizophrenia (TRS) has been defined as the persistence of positive symptoms despite two or more trials of antipsychotic medication of adequate dose and duration. TRS is a serious clinical problem and occurs in approximately 30% of patients with schizophrenia. It is important that patients who do not adequately respond to antipsychotics be reevaluated to exclude or address causes other than non-responsiveness to medication, that is, the possibility of pseudo-resistance. In particular, non-adherence to oral antipsychotic treatment should be monitored to rule out pseudo-resistant cases of TRS. Moreover, patients with TRS who take their medication as required may have subtherapeutic antipsychotic plasma levels, secondary to pharmacokinetic factors. In this paper, we review the concept and exclusion of pseudo-resistance, especially owing to non-adherence or pharmacokinetic factors, and present methods to enhance drug adherence.

• Tuberculosis and Respiratory Diseases
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• v.86 no.2
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• pp.82-93
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• 2023

Tuberculosis (TB) is a significant public health concern. Globally, TB is among the top 10 and the leading cause of death due to a single infectious agent. Providing standard anti-TB therapy for at least 6 months is recommended as one of the crucial strategies to control the TB epidemic. However, the long duration of TB treatment raised the issue of non-adherence. Non-adherence to TB therapy could negatively affect clinical and public health outcomes. Thus, directly observed therapy (DOT) has been introduced as a standard strategy to improve anti-TB medication adherence. Nonetheless, the DOT approach has been criticized due to inconvenience, stigma, reduced economic productivity, and reduced quality of life, which ultimately could complicate adherence issues. Apart from that, its effectiveness in improving anti-TB adherence is debatable. Therefore, digital technology could be an essential tool to enhance the implementation of DOT. Incorporating the health belief model (HBM) into digital technology can further increase its effectiveness in changing behavior and improving medication adherence. This article aimed to review the latest evidence regarding TB medication non-adherence, its associated factors, DOT's efficacy and its alternatives, and the use of digital technology and HBM in improving medication adherence. This paper used the narrative review methodology to analyze related articles to address the study objectives. Conventional DOT has several disadvantages in TB management. Integrating HBM in digital technology development is potentially effective in improving medication adherence. Digital technology provides an opportunity to improve medication adherence to overcome various issues related to DOT implementation.

• Research in Community and Public Health Nursing
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• v.24 no.4
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• pp.419-426
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• 2013

Purpose: The purpose of this study is to examine factors influencing medication adherence in patients with hypertension. Methods: This study carried out a secondary analysis of data from the 2008 Korean National Health and Nutrition Examination Survey (KNHANES). Stratified sampling was used to select a participant sample that was representative of patients with hypertension throughout the country. Using the SPSS/WIN 18.0 program, data were analyzed using descriptive statistics, $x^2$ test, t-test, and logistic regression. Results: Of the patients with hypertension, 8.8% had showed non-adherence to medication. Medication adherence was associated with age, spouse, Medicare insurance, number of other diseases, and current smoking status. The cases with older age, a spouse, Medicare insurance, higher number of other diseases, and no current smoking status showed significantly high medication adherence. Conclusion: Nursing interventions and further studies are needed to achieve high levels of medication adherence based on factors influencing medication adherence such as age, spouse, Medicare insurance, number of other disease, and current smoking status.