1. Role of Emotion and Reason in Medication Adherence of Older Women
Christine Unson, PhD and Morenike Akpo, MPH
Public Health Department, Southern Connecticut State University, New Haven, CT
Ross Buck, PhD
Communication Sciences Department, University of Connecticut, Storrs, CT
Supported by grant from Columbia Center for Active Life of Minority Elders, Columbia University

2. Although nonadherence to medications is problematic for all age groups, older adults are faced with several obstacles to adherence such as vision loss, cognitive impairment and co-morbidities, and are at-higher risks for adverse events due to improper use of medications (van Eijken, Tsang, Wensing, de Smet, & Grol, 2003) (Schlenk, Burke, & Rand, 2001).
Estimates of non-adherence (between 26% and 60%) among older adults indicate that the problem is widespread (Higgins & Regan, 2004; van Eijken et al., 2003); (Schlenk et al., 2001).
Outcomes of medication nonadherence such as treatment failure and adverse drug effects, may lead to increased mortality and morbidity, and increased hospitalization and nursing home costs (Cleemput, 2002).

3. Medication adherence has been defined as “taking the correct amounts on the correct dosing schedule in accordance with any special instructions” (McDonald-Miszczak, Maris, Fitzgibbon, & Ritchie, 2004).
Research findings suggest that nonadherence may be “unwitting” (i.e., related to failure to understand or remember instruction or lack of skills necessary to carry out complex treatment regimens) or “intentional” (i.e., a deliberate decision not to follow a prescribed regimen) (Schlenk et al., 2001).
The many factors that have been associated with nonadherence can be categorized as: a) individual (e.g., knowledge, attitudes and beliefs about medications); b) interpersonal (support from health provider and significant others, etc.); and environmental (e.g., access and costs) (Ockene, 2001).
r A review of published studies on medication adherence suggests that other than multiple medications and poor patient-healthcare provider relationships, the associations between medication adherence and the aforementioned factors have not been empirically supported.(Vik, Maxwell, & Hogan, 2004). The review concludes with a call for more research on individual factors affecting non-adherence.

4. Medication adherence has been defined as “taking the correct amounts on the correct dosing schedule in accordance with any special instructions” (McDonald-Miszczak, Maris, Fitzgibbon, & Ritchie, 2004).
Research findings suggest that nonadherence may be “unwitting” (i.e., related to failure to understand or remember instruction or lack of skills necessary to carry out complex treatment regimens) or “intentional” (i.e., a deliberate decision not to follow a prescribed regimen) (Schlenk et al., 2001).
The many factors that have been associated with nonadherence can be categorized as: a) individual (e.g., knowledge, attitudes and beliefs about medications); b) interpersonal (support from health provider and significant others, etc.); and environmental (e.g., access and costs) (Ockene, 2001).
r A review of published studies on medication adherence suggests that other than multiple medications and poor patient-healthcare provider relationships, the associations between medication adherence and the aforementioned factors have not been empirically supported.(Vik, Maxwell, & Hogan, 2004). The review concludes with a call for more research on individual factors affecting non-adherence.

10. Mean adherence rate: 6.7, SD = .9

12. Mean = 4.6, SD = 1.4

13. (McDonald-Miszczak et al., 2004)

19. Beta t
Sig.
(Constant)
9.198
.001
Negative emotions
-.078
-.796
.43
Positive emotions
.233
2.299
.02
Knowledge of medications
-.012
-.118
.91
Affordable
-.201
-2.132
.04
Simplify medication schedule
.009
.089
.93
Med schedule is easy to remember
.391
3.916
Years of education
-.174
-1.647
.10
Adjusted R2 = .24, F(7,81) = 4.87, p < .001