• Journal of Korean Biological Nursing Science
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• v.19 no.1
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• pp.18-29
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• 2017

Purpose: This study investigates the status of medication use of the elderly with chronic disease taking non-opioid analgesics and attempts to identify factors influencing medication adherence. Methods: Data were collected from September 1 to October 19, 2016. A structured questionnaire was used for face-to-face interview with a convenience sample of 161, elderly people with chronic disease taking non-opioid analgesics. The survey included questions about status of medication use, medication adherence, symptom experience, depression and family function. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression with IBM SPSS 23.0 program. Results: The mean score of medication adherence of the elderly with chronic disease was $4.48{\pm}2.35$. Experiences of side effects (${\beta}=.31$, p< .001), use of over-the-counter pain medication (${\beta}=.19$, p= .009), and family function (${\beta}=.16$, p= .031) were identified as significant predictors. The final model explained 18.0% of the variation of medication adherence of the elderly with chronic disease taking non-opioid analgesics (F= 12.30, p< .001). Conclusion: Therefore, as a strategy to improve medication adherence of the elderly with chronic disease, therapeutic intervention should be developed to improve family function and to manage with personalized plans considering experiences of side effects and use of over-the-counter pain medication.

• Journal of Korean Biological Nursing Science
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• v.24 no.3
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• pp.200-207
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• 2022

Purpose: Medication adherence in older adults with multimorbidity is critical for self-care. The purpose of this cross-sectional study was to identify the factors that influence medication adherence in older adults with multimorbidity. Methods: The patients were 116 adults 65 or older with three or more chronic diseases. The data were collected from December 2020 to April 2022 in outpatient clinics at a hospital in Daejeon. Results: The mean scores of depression, social support, and medication adherence were 16.18± 6.74 (of 30), 41.06± 6.56 (of 60), and 4.69± 1.85 (of 8) points, respectively. Patients with low adherence comprised the most with 75 patients (64.7%). Influencing factors on medication adherence were depression (β= -.35, p= .007) and family support among social support (β= .29, p= .006). Conclusion: Among older adults with multimorbidity, lower depression as well as higher family support, results in higher medication adherence. It is necessary to develop a practical strategy toward improving medication adherence, by sensitively managing the degree of depression, as well as strengthening family support.

• Journal of Korean Public Health Nursing
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• v.28 no.1
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• pp.32-45
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• 2014

Purpose: The purpose of this study was to test the effectiveness of an eight session integrated case management program for improvement of medication adherence, physical function, pain, and depression among medical aid beneficiaries with osteoarthritis. Method: A nonequivalent control group pre-posttest design was employed. Participants were 55 medical aid beneficiaries who agreed to participate in this study, and were assigned to an experimental group (n=28) or control group (n=27). The framework of this research derived from Cox's Interaction Model of Client Health Behavior guided the overall intervention and the components. The program led by a case manager with a medication calendar, motivating interviewing and coaching strategies and collaboration with a pharmacist. Analysis included change in scores, ${\chi}^2$-test, and t-test. Result: The results showed significant increase in medication adherence, physical function and decrease joint pain, joint stiffness and depression in the experimental group compared to the control group. Conclusion: The eight session integrated case management program indicated an effect on medication adherence, pain, physical function, and depression. Partnership with a pharmacist is recommended for medication adherence and conduct of further studies will be needed in order to determine the long-term effect of an extended integrated program on health outcomes.

• Journal of Korean Clinical Nursing Research
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• v.21 no.2
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• pp.234-242
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• 2015

Purpose: The purpose of this study was to investigate the levels of knowledge and medication adherence to hormonal therapy (HT) and to identify the factors influencing medication adherence for patients with breast cancer. Methods: Data were collected from 136 patients undergoing adjuvant HT for breast cancer in 3 general hospitals from July 1 to August 14 in 2014 using self-report questionnaires. Data were analyzed using descriptive statistics, independent t-test, ANOVA, $Scheff{\grave{e}}$ test, and multiple regression. Results: The average of knowledge about HT was $5.15{\pm}2.22$ (Max 9), and that of medication adherence was $5.76{\pm}1.65$ (Max 8). Younger age, shorter duration of HT, more active participation in decision making for treatment, positive perception for impacts of HT, and stronger belief in cure were influencing factors on higher adherence level. Age, duration of HT, and perception on the impacts of hormonal therapy, and belief in cure explained 25.2% of the adherence. Conclusion: To improve the treatment adherence to hormonal therapy, patient education and involvement in decision making, and the tailored intervention for the patients with older age, and long treatment period of HT are needed. Additionally, the strategies for diminishing unintentional forgetting is necessary to be developed.

• Research in Community and Public Health Nursing
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• v.22 no.3
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• pp.290-301
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• 2011

Purpose: This study is a descriptive research intended to clarify the medication status of community-dwelling elders and to identify factors affecting their medication adherence. Methods: Data were collected using questionnaires and interviews from 101 subjects who had taken prescribed drugs for at least 7 days sampled among elderly people using home care nursing at a general hospital in Seoul. Results: According to the results of this study, medication adherence measured by pill counting was 88.3% and that measured by self-reporting was 94.6%. There were statistically significant differences in medication adherence according to major disease (p=.006), the number of admissions (p=.032), the number of drugs (p=.051), the frequency of medication (p=.026), and depression (r=-.205). In addition, depression was found to be a significant variable explaining the medication adherence with explanatory power 3.8% (p=.035). Conclusion: The presence of depression affected the elderly subjects' the medication adherence. Therefore, more concern and educational approaches are required to encourage elderly people to comply correctly with medication regimens particularly for elderly patients who have a malignant or long-lasting disease or who have to take multiple drugs or maintain a daily dosing frequency.

• Journal of muscle and joint health
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• v.25 no.1
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• pp.30-38
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• 2018

Purpose: The purposes of this study were to examine the relationships between health literacy, self-efficacy, social support, and medication adherence and to determine its impact on medication adherence in the elderly. Methods: This study was a descriptive research study. Structured questionnaires were used for survey with a convenience sample of 220 elderly in a community. Data were analyzed using descriptive statistics, ANOVA, Pearson's correlation coefficient, and stepwise multiple regression with IBM SPSS 18.0. Results: The mean scores of health literacy, self-efficacy, social support, and medication adherence were $35.89{\pm}19.39$, $55.34{\pm}7.44$, $86.54{\pm}15.90$ and $4.82{\pm}1.83$, respectively. There were significant correlations between health literacy, self-efficacy, social support, and medication adherence. Social support (${\beta}=.23$, p=.001) and health literacy (${\beta}=.21$, p=.002) were significantly associated factors with medication adherence. Conclusion: This finding showed that nursing interventions to promote medication adherence in the elderly group should focus on social support program and health literacy intervention.

• Research in Community and Public Health Nursing
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• v.24 no.4
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• pp.419-426
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• 2013

Purpose: The purpose of this study is to examine factors influencing medication adherence in patients with hypertension. Methods: This study carried out a secondary analysis of data from the 2008 Korean National Health and Nutrition Examination Survey (KNHANES). Stratified sampling was used to select a participant sample that was representative of patients with hypertension throughout the country. Using the SPSS/WIN 18.0 program, data were analyzed using descriptive statistics, $x^2$ test, t-test, and logistic regression. Results: Of the patients with hypertension, 8.8% had showed non-adherence to medication. Medication adherence was associated with age, spouse, Medicare insurance, number of other diseases, and current smoking status. The cases with older age, a spouse, Medicare insurance, higher number of other diseases, and no current smoking status showed significantly high medication adherence. Conclusion: Nursing interventions and further studies are needed to achieve high levels of medication adherence based on factors influencing medication adherence such as age, spouse, Medicare insurance, number of other disease, and current smoking status.

• Health Policy and Management
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• v.31 no.3
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• pp.292-300
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• 2021

Background: Medication adherence in hypertension is the most important to control blood pressure and prevent major complications. The purpose of this study was to identify factors affecting medication adherence and to examine the relationship between medication adherence and blood pressure control in Korea. Methods: This study used data from the 7th Korea national health and nutrition examination survey (2016-2018) of the Korea Disease Control and Prevention Agency. We selected 4,063 hypertensive patients from the data. And we choose socio-demographic, health behavior, healthcare utilization, and severity characteristics as hypertensive patient characteristics. Results: Of the patients with hypertension, 92.3% had shown adherence to medication as of 2016-2018 and shows variation according to the characteristic of patients. The cases with male, under 50 years old, urban area, single household, unmet medical services, less than 5 years of hypertension duration, no comorbidities (diabetes mellitus, myocardial infarction) showed significantly low medication adherence. After adjusting for confounders, adherent patients tended to have lower current systolic blood pressure (β=-10.846, p<0.001) and diastolic blood pressure (β=-5.018, p<0.001) than nonadherent patients. And, adherent patients increased the control odds of blood pressure compared with nonadherent patients (odds ratio, 3.02; 95% confidence interval, 2.21-4.12). Conclusion: This study confirmed that adherence to antihypertensive drugs was effective in controlling blood pressure. In order to more actively manage hypertensive patients at the national level, it is necessary to make an effort to improve the medication compliance of nonadherent groups, such as early-diagnosis patients, young patients under 50 years of age, and patients living alone.

• Korean Journal of Clinical Pharmacy
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• v.26 no.2
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• pp.128-136
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• 2016

Objective: This study was to explore the association between having a usual source of care and adherence to medicines in patient with chronic diseases. Methods: The 2012 Korea Health Panel was used as a data source. We analyzed 4,418 respondents that were diagnosed with chronic diseases and utilized health care services. Non-adherence to medication, a dependent variable, was defined as "not taking the medicines that were prescribed for treating chronic disease" or "not following the direction for medication". Whether having a usual source of care or not was used as a key independent variable, which was defined as having a regular site or a regular doctor for medical test, treatment, and consultation. Sex, age, education level, marital status, income, the type of health insurance, the number of chronic disease and CCI (Charlson Comorbidity Index) were included as covariates in the analysis. We conducted a multivariate logistic regression. Results: Totally, 30 percent of respondents reported to experience non-adherence to medication. Having a usual source of care was significantly associated with lower non-adherence to medication regardless its type, which is a regular doctor (OR=0.61, 95% CI=0.53-0.70) or a regular site (OR=0.67, 95% CI=0.58-0.78). Furthermore, having a usual source of care was associated with both of medication persistence (OR=0.66, 95% CI=0.54-0.81) and compliance (OR=0.65, 95% CI=0.56-0.76). Conclusion: Our results showed the possibility that usual source of care is able to conduct a positive role in improving adherence to medication with better management of chronic disease.

• Journal of Korean Clinical Nursing Research
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• v.25 no.2
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• pp.170-178
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• 2019

Purpose: The purpose of this study was to determine the mediating effects of self-efficacy and the belief about medication on the association between depression and medication adherence in patients with systemic lupus erythematosus. Methods: 128 patients aged ${\geq}19years$, who were regular outpatients or admitted patients diagnosed with systemic lupus erythematosus at a tertiary hospital in B city, participated in this study. Data were collected by using a self-administered questionnaire. Testing of mediating effects was analyzed by a parallel redundant mediated model using the PROCESS macro for SPSS version 3.3. Results: They scored an average of $16.71{\pm}11.13$ for depression, $694.14{\pm}170.68$ for self-efficacy, $3.05{\pm}4.60$ for the belief about medication, and $90.14{\pm}15.37$ for medication adherence. The direct effect of depression on medication adherence was not statistically significant, but the indirect effects of depression mediated with self-efficacy and belief about medication were statistically significant. Conclusion: It is necessary to develop and apply a nursing intervention program that can not only relieve depression but also promote self-efficacy and the belief about medication with the objective of improving medication adherence among patients with systemic lupus erythematosus.