CHAPTER ONE

1. INTRODUCTION

1.1   BACKGROUND OF STUDY

Adherence to medications has always been a problem among elderly patients. As elderly people are prone to multiple co morbidities, they are at higher risk of polypharmacy and therefore may present with higher risk of non adherence to medications compared to the younger population. Medication non-adherence lowers the effectiveness of treatments and raises medical costs. There are many different methods for assessing adherence to medications such as patient questionnaires, self-reports, pill counts, assessment of the patient’s clinical response, measurement of physiological markers and patient diaries.

Medication adherence is the extent to which a person's behavior agrees with the agreed medication regimen from a health care provider. Ramanath KV, Balaji (2003). An older patient is defined as a person who is aged 65 years and above. Adherence is a multifactorial phenomenon and varies from population to population.

Factors such as age, gender, socioeconomic status and level of disease severity, complexity of prescribed medications, social acceptance, poor patient related relationships, cost, forgetfulness and presence of psychological problems have all been shown to contribute to the adherence in various populations.

Saleem F, Hassali M,(2002). Medication non-adherence is the multifaceted problem, responsible for increasing the important medical and public health issues like worsened therapeutic outcome, higher hospitalization rates, and increased health care costs. Ramanath KV, Balaji (2003). It is common for older patient to be treated for different health conditions simultaneously, and this can result in a complex medication regime. As well as presenting pharmacological risks, poly pharmacy, defined as simultaneous and chronic use of multiple medications, predisposes those practicing it to low adherence.

Many factors may influence medication compliance in elderly population, including unclear instructions, inadequate patient education, lack of patient involvement in the treatment plan, medication cost, side effects and the complexity of the dosing regimen.

Many studies have shown that most of the elderly people do not take their medications at the right time or in the right amount because of complicating factors such as the number of medications prescribed and the number of providers seen for multiple health problems, as well as other physical and cognitive challenges the elderly face. Lack of knowledge of their illnesses and the role medicines play in their long-term management can lead to intentional medication non-adherence.

Strong evidence shows that elderly patients with chronic illnesses have difficulty adhering to their recommended medication regimen. To improve medication adherence, the multi-factorial causes of decreased adherence must be understood. The multifactorial nature of poor medication adherence implies that only a sustained, coordinated effort will ensure optimal medication adherence and realization of the full benefits of current therapies. Therefore the purpose of our study is to identify the factors contributing to the adherence to treatment regime among residence among older patients in Ughelli.

1.2   STATEMENT OF THE PROBLEM

        In medication, adherence to treatment regimen matters a lot most especially with the older residents but most at times it is challenging to observe that most older residents do not adhere to the treatment which might be as a result of cost of continuing the treatment, and sometimes they don’t adhere cause the severity of the sickness has been reduced, and some could be that they cannot follow the instructions (might have forgotten or illiterate ones that cannot read or write). Finally, several researches have been carried out on the influence of non-adherence to medication but not even a single research has been carried out on the factors contributing to the treatment regimen among older residents in Ughelli.

1.3   AIMS AND OBJECTIVES OF STUDY

        The main aim of the study is to determine the factors contributing to adherence to treatment regimen among older residents. Other specific objective of the study includes;

1. to determine the factors affecting adherence to treatment among older residence in Ughelli.
2. to determine the effect of adherence to treatment among older residence in Ughelli.
3. to determine the extent to which non-adherence to treatment regimen affects older resident in Ughelli.
4. to proffer possible solutions to the problems.
   1. RESEARCH QUESTIONS               

1      What are the factors affecting adherence to treatment among older residence in Ughelli?

2      What is the effect of adherence to treatment among older residence in Ughelli?

3      What is the extent to which non-adherence to treatment regimen affects older resident in Ughelli?

4      What are the possible solutions to the problems?

1.5   STATEMENT OF RESEARCH HYPOTHESIS

H0:   Adherence to treatment regimen has no significant effect on older residents.

H1:      Adherence to treatment regimen has a significant effect on older residents.

1.6   SIGNIFICANCE OF STUDY

        The study on the factors contributing to the adherence to treatment regimen among older residents will be of immense benefit to the entire elderly persons in Ughelli in the sense that it will educate them on the side effect of not adhering to the instructions that guides the treatment. The study will enable the caregivers or medical personnel to interpret in a language that will be to the understanding of the older residents to avoid misunderstanding. Finally, the study will contribute to the body of existing literature and knowledge to this field of study and basis for further research.

1.7   SCOPE OF STUDY

        The study on the factors contributing to adherence to treatment regimen among older residents is limited to Ughelli.

1.8   LIMITATION OF STUDY

Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.

1.9   DEFINITION OF TERMS

Adherence       The act of doing something according to a particular rule, standard, agreement, etc.

Regimen  A prescribed course of medical treatment, diet, or exercise for the promotion or restoration of health.