Patterns of medication use and adherence to medications among residents in the elderly homes

OBJECTIVE: To evaluate health care related to medication regimens among institutionalized elders in Damanhour, Beheira Governate, Egypt. METHODS: A prospective, multi-centered, observational study was conducted in the two elderly residential homes in Damanhour between March and May 2017. A questionnaire was developed and validated to test for elderly socio-economic, chronic diseases, current therapy adherence, vaccination history and patient education. Descriptive and quantitative analysis were performed. RESULTS: sixty-three elderly residents were included in the study. The sample showed broad socioeconomic variability posing a true reflection of Egyptian population. 63.5% had no hearing problems, 31.7% had proper vision and 57% could move with no help. More than three quarters had chronic diseases of which 58.7% were previously hospitalized. The most prevalent diseases were hypertension, diabetes and arthritis 46%, 41.3%, 26.9% respectively. Only 7.9% and 4.7% showed chronic liver and kidney diseases, respectively and less than 10% suffered from respiratory related diseases. No alcohol drinker, 25.3% were smokers and 58.7% drank caffeine. Only 25.3% of residents showed full adherence to their medication pattern. Approximately 80% of residents never received proper patient education. Forty-three residents did not know the indication of their medications and 92% ignored its side effects. CONCLUSION: Absence of proper medical care exposure for the elderly residents was reflected in their low medication adherence, adverse side effects and hospitalization. We suggest extension of the national medical insurance system to include larger number of elderly population. To monitor the care given concerning medication, a daily resident gerontological nurse needs to be assigned, visits by clinical pharmacists weekly or bi-weekly from the nearby governmental hospital can improve improper medication.