Gender Based Cognitive Determinants Of Medication Adherence In Older Adults With Chronic Conditions

Figures & data

Table 1 Characteristics Of The Participants In The Study (n=455)

Variables	Frequency (%)
Gender
Male	216 (47.5)
Female	239 (52.5)
Marital status
Married	309 (67.9)
Single	146 (32.1)
Living alone
Yes	79 (17.4)
No	376 (82.6)
Job status
Employed	44 (9.7)
Unemployed	411 (90.3)
Education level
Literate	252 (55.4)
Illiterate	203 (44.6)
Having insurance
Yes	433 (95.2)
No	22 (4.8)
The number of drugs prescribed by a doctor
1 to 4	206 (45.3)
5 to 10	241 (53.0)
Up to 10	8 (1.8)
Use of OTC drugs
None	354 (77.8)
Taking one medications	63 (13.8)
Taking two medications	33 (7.3)
Taking more than two medications	5 (1.1)
Type of dosage forms
Tablet	278 (61.1)
Tablet and capsule	177 (38.9)
Do you need assistance for medication administration?
Yes	84 (18.5)
No	371 (81.5)
	Mean (±SD)
Age	67.95 (5.24)

Table 2 Normal Distribution For Cognitive Factors Scores Among Older Patients (n=455)

	Variables	Mean	SD	Skewness	Kurtosis
1	Medication Adherence	3.01	1.52	−0.50	−0.79
2	Medication Adherence Self-Efficacy	40.00	8.49	−0.68	0.01
3	Medication Knowledge	6.17	1.75	−0.08	0.166
4	Beliefs about Medicines	58.06	10.36	−0.46	0.23
5	Medication Adherence Reason	75.00	29.73	0.66	0.60
6	Brief Illness Perception	54.30	10.63	−0.58	1.20

Table 3 Demographic Characteristics And Medication By “Non-Adherent” And “Adherent” Among Older Patients (n=455)

Variables	Level Of Adherence		P-value
	*Non-Adherent	**Adherent
Gender
Male	131 (54.8%)	108 (45.2%)	0.925
Female	117 (54.2%)	99 (45.8%)
Marital status
Married	154 (49.8%)	155 (50.2%)	0.005
Single	94 (64.4%)	52 (35.6%)
Living alone
Yes	50 (63.3%)	29 (36.7%)	0.106
No	198 (52.7%)	178 (47.3%)
Job status
Employed	25 (56.8%)	19 (433.2%)	0.754
Unemployed	223 (54.3%)	188 (45.7%)
Education level
Literate	140 (55.6%)	112 (44.4%)	0.637
Illiterate	108 (53.2%)	95 (46.8%)
Having insurance
Yes	230 (53.1%)	203 (46.9%)	0.008
No	18 (81.8%)	4 (18.2%)
The number of drugs prescribed by a doctor
1 to 4	111 (44.8%)	95 (45.9%)	0.901
5 to 10	132 (53.2%)	109 (52.7%)
Up to 10	5 (2.0%)	3 (1.4%)
Use of OTC drugs
None	187 (75.4%)	167 (80.7%)	0.126
Taking one medications	35 (14.1%)	28 (13.5%)
Taking two medications	21 (8.5%)	12 (5.8%)
Taking more than two medications	5 (2.0%)	0 (0.0%)
Type of dosage forms
Tablet	148 (59.7%)	130 (62.8%)	0.501
Tablet and capsule	100 (40.3%)	77 (37.2%)
Do you need assistance for medication administration?
Yes	54 (64.3%)	30 (35.7%)	0.052
No	194 (52.3%)	177 (47.7%)

Notes: *MAS score<3. **MAS score≥3.

Table 4 Factors Associated With Drugs Adherence Among Male And Female Older Patients (n=455)

Variables	Male		Female
	Unadjusted OR(95% CI)	P–value	Unadjusted OR(95% CI)	P–value
Marital status
Married	2.23 (1.16, 4.28)	0.016	1.60 (0.94, 2.73)	0.08
Single	Reference	–	–	–
Living alone
No	2.58 (1.13, 5.85)	0.023	1.09 (0.57, 2.08)	0.795
Yes	Reference	–	–
Job status
Employed	0.96 (0.44, 2.08)	0.92	1.52 (0.49, 4.67)	0.466
Unemployed	Reference	–	–
Education level
Literate	0.96 (0.56, 1.65)	0.900	1.23 (0.74, 2.06)	0.418
Illiterate	Reference	–	–
Having insurance
Yes	0.28 (0.05, 1.35)	0.114	0.22 (0.04, 1.06)	0.06
No	Reference	–	–
The number of drugs prescribed by a doctor
1 to 4	2.12 (0.21, 21.14)	0.519	1.04 (0.14, 7.68)	0.969
5 to 10	3.11 (0.31, 30.91	0.332	0.68 (0.09, 5.02)	0.712
Up to 10	Reference	–	–	–
Use of OTC drugs
None	1.88 (0.72, 4.90)	0.196	2.05 (0.69, 6.04)	0.193
Taking one medications	1.38 (0.43, 4.31)	0.593	2.25 (0.63, 7.92)	0.207
Taking two/more than two medications	Reference	–	–	–
Type of dosage forms
Tablet	1.05 (0.54, 2.02)	0.875	1.04 (0.53, 2.02)	0.900
Tablet and capsule	Reference	–	–
Do you need assistance for medication administration?
Yes	1.45 (0.77, 2.73)	0.238	2.10 (0.91, 4.80)	0.079
No	Reference	–	–
Medication Adherence Self-Efficacy	1.06 (1.02, 1.10)	0.001	1.03 (1.00, 1.07)	0.028
Medication Knowledge	1.04 (0.89, 1.21)	0.578	0.973 (0.84, 1.25)	0.714
Beliefs about Medicines	0.97 (0.94, 0.99)	0.028	0.96 (0.93, 0.98)	0.003
Medication Adherence Reason	0.94 (0.92, 0.97)	0.001	0.96 (0.94, 0.99)	0.021
Illness Perception	0.99 (0.96, 1.02)	0.708	1.01 (0.99, 1.04)	0.126

Note: Simple linear logistic regression and univariate analysis (unadjusted ORs).

Table 5 Final Model Of Predictors For Drugs Adherence Among Male And Female Older Patients (n=455)

	Variables	Male (n=216)		Female (n=239)
		Adjusted OR (95% CI)	P-value	Adjusted OR (95% CI)	P-value
1	Marital status
	Yes	2.46 (1.23, 4.93)	0.011	2.05 (1.39, 4.78)	0.009
	No	Reference	–	–	–
2	Living alone
	No	0.77 (0.24, 2.42)	0.662	1.76 (0.72, 4.27)	0.210
	Yes	Reference	–	–	–
3	Medication Adherence Self-Efficacy	1.04 (1.00, 1.08)	0.028	1.01 (0.97, 1.05)	0.406
4	Medication Knowledge	0.96 (0.80, 1.15)	0.689	0.99 (0.83, 1.17)	0.927
5	Beliefs about Medicines	0.98 (0.95, 1.01)	0.310	0.95 (0.93, 0.98)	0.001
6	Medication Adherence Reason	0.96 (0.92, 0.99)	0.041	0.98 (0.95, 1.02)	0.473
7	Brief Illness Perception	1.00 (0.97, 1.04)	0.599	1.02 (1.00, 1.05)	0.035

Notes: 3=Medication Adherence Self-Efficacy scale, 5= Beliefs about Medicines, 6= Medication Adherence Reason, 7=Illness Perception. Results of logistic regression with Backward elimination: final model. We ran logistic regression analyses that used full model and Backward entry methods. Bold font indicates statistical significance.

Table 6 Person Correlation Between Cognitive Factors Among Older Patients (n=455)

	1	2	3	4	5	6
1-Medication Adherence	1
2-Medication Knowledge	−0.017	1
3-Beliefs about Medicines	−0.248**	−0.013	1
4-Medication Adherence Reason	−0.292**	−0.114*	0.370**	1
5-Medication Adherence Self-Efficacy	0.369**	0.125**	−0.358**	−0.478**	1
6-Brief Illness Perception	−0.015	−0.046	0.274**	0.076	0.019	1

Notes: **Correlation is significant at the 0.01 level (2-tailed). *Correlation is significant at the 0.05 level (2-tailed).

Table 7 Distribution Of Responses Across The MARS For Medications Among Older Patients (n=455)

Items Of Medication Adherence Reasons Scale	None Of The Time (%)	A Little Of The Time (%)	Some Of The Time (%)	Most Of The Time (%)	All The Of Time (%)
1-Difficulty swallowing	4.4	6.2	20.4	18.7	50.3
2-Unclear about proper administration	5.3	5.9	14.9	26.6	47.3
3-Embarrassment in taking medications	1.5	5.3	7.5	13.4	72.3
4-Problems opening containers	3.7	3.1	6.6	16	70.5
5-Cost of medications	20.7	2	30.8	14.1	32.5
6-Taking too many medications	17.4	2	32.7	18	29.9
7-Concern about long-term effects of medication	13.6	2.4	28.6	26.6	28.8
8-Medication is ineffective	5.3	4.8	25.9	28.1	35.8
9-Side effects/fear of side effects	6.8	4.4	28.1	26.2	34.5
10-Medication is not needed	7.3	4.2	20.9	24.4	43.3
11-Stop medication to see whether it is still needed	5.5	5.1	18.7	23.5	47.3
12-Forget due to busy schedule	5.5	5.7	27.7	25.7	35.4
13-Inconvenience in taking medications in prescribed way	7.7	5.7	30.1	28.4	28.1
14-Medication not available in the pharmacy	6.4	6.4	24.2	24.8	38.2
15-Ran out of prescription	10.1	9.5	21.1	20.0	39.3