Influence of cultural background and medication-taking style on medication adherence, "Beyond the Abstract," by Snezana Kusljic, PhD, BSci (Hons) and Elizabeth Manias

BERKELEY, CA (UroToday.com) - It is clear that medication-related problems such as the frequency of missing a dose of medication, inaccurate dosages, and incorrect route of administration are very common in people with chronic illness. Poor medication adherence is usually associated with complex dosage regimens required to manage chronic illness, administration of medications at inconvenient times, and adverse drug reactions or side effects relating to medications.[1] Furthermore, people who take medications for their chronic condition sometimes lack in-depth knowledge about their purpose, the way these medications work, and adverse effects associated with their use.[1]

Age-dependent enlargement of the prostate gland is just one of many chronic conditions that will require some sort of medication regimen for life. There is not much we can do in terms of prevention of this age-dependent condition, but we can definitely improve medication adherence in this population. Better medication adherence will not only reduce the burden of chronic illness on health care expenditure, but more importantly, improve the emotional, social, and financial needs of people with chronic illness. We have recently identified factors that help explain the lack of medication adherence in men with prostatic enlargement.[2] Our study revealed a clear association with cultural background and medication-taking style on medication adherence. Men from a non-English speaking background and men who received help from their caregivers were less likely to complain about their medications, which in turn, resulted in better medication adherence.

In this commentary, we would like to emphasize two important points. The first point relates to the small sample size. We found it very difficult to recruit patients through the urology outpatient clinic in a Melbourne metropolitan teaching hospital. This difficulty in the recruitment process could be related to the fact that most patients with benign enlargement of the prostate gland receive their routine care at the local general practice clinics. Additionally, older people almost always associate specialists’ appointments with extra financial burden, thus avoiding frequent visits to the urology clinics. Therefore, we suggest that future studies should involve general practice clinics for recruitment of patients and also for obtaining detailed information on cultural diversity within a particular community.

Secondly, we believe that providing continuous support to people with chronic illness and continuity of care plays an important role in medication adherence. We must ensure, therefore, that people with chronic illness remain closely connected to their health care providers and/or members of their own community. It is well known that prescribers do not have sufficient time to provide in-depth detail about medications in their consultations. In order to improve medication adherence it is critical to develop programs that will involve regular discussions and/or focus groups on the action of medications, reason for prescription, and associated adverse effects. These discussions could be organized in local general practice clinics and community health centres, and, if possible, they should include family members or caregivers. Furthermore, we could look into development of a mobile phone system where people receive regular reminders about their medications such as mobile phone alarms. All of these strategies could be of great assistance to people with chronic illness.

References:

  1. Chan, F.W., Wong, F.Y., So, W.Y., Kung, K. & Wong, C.K. 2013. How much do elders with chronic conditions know about their medications? BMC Geriatrics. 13, 59.
  2. Kusljic, S., Manias, E., Tran, B & Williams, A. 2013. Enablers and barriers affecting medication-taking behaviour in aging men with benign prostatic hyperplasia. The Aging Male. 16 (3), 112-117.

Written by:
Snezana Kusljic, PhD (Melb), BSci (Hons)* and Elizabeth Manias as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.

*Senior Lecturer - Department of Nursing
The University of Melbourne
Level 6, Alan Gilbert Building
161 Barry Street
Carlton VIC 3053, Melbourne, Australia
Email:

Enablers and barriers affecting medication-taking behaviour in aging men with benign prostatic hyperplasia - Abstract

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