A Qualitative Study of Medication Adherence among Older Adults in San Juan, Puerto Rico

By Denise Lebrón Tricoche and Joann Kovacich.

Published by The International Journal of Aging and Society

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Article: Print $US10.00
Article: Electronic $US5.00

In the United States, nearly 33% to 69% of hospital admissions are due to poor adherence to medication, costing the industry $100 billion each year. Improving adherence to medication among older adults has become a challenging and pressing problem. Medication adherence is a complex behavior influenced by patients’ beliefs and knowledge related to their therapeutic treatment. Informed by Becker’s Health Belief Model and Bandura’s Self-Efficacy Model, twenty-six older adults in two community centers in San Juan, Puerto Rico were interviewed to explore medication adherence within the context of medication regimen, medication effectiveness, medication management, medication side effects, and medication cost. The following descriptive themes emerged as contributing factors for medication adherence: (a) patient health condition(s) and treatment perception, (b) medication side effects, (c) patient time preference for taking medication, (d) family support, (e) health insurance treatment coverage and (f) increased health decline as a result of aging. The most prominent influencers for medication adherence were treatment perception, knowledge of disease and understanding of treatment prescribed, medication management preferences, and family support. The study findings highlight the need to develop innovative programs to improve adherence among older adults with chronic diseases.

Keywords: Medication Adherence, Older Adults, Health Belief Model, Self-efficacy

The International Journal of Aging and Society, Volume 2, Issue 2, pp.71-82. Article: Print (Spiral Bound). Article: Electronic (PDF File; 425.224KB).

Dr. Denise Lebrón Tricoche

Graduate Student, Health Administration, University of Phoenix, Phoenix, AZ, USA

Dr. Denise Lebrón Tricoche was born in the state of New Jersey, lived in Puerto Rico for over 25 years, and since 2011 has been a resident of the state of Maine. She recently earned her DHA in Health Administration from University of Phoenix, Arizona, received her MIS in Information System from EDP College of Hato Rey and BS in Biology from Pontificia Catholic University of Ponce in Puerto Rico. During her professional career, she provided quality assurance services to Pfizer, Pharmacia & Upjohn, and GlaxoSmithKline. She is a former professor and faculty staff member from two recognized universities of San Juan Puerto Rico: University of Puerto Rico (UPR) and Interamerican University of Puerto Rico (UIPR). She taught graduate and undergraduate courses in areas of business administration, computer science, and management of information systems. As a former Principle Investigator and faculty member of UIPR, she developed a proposal titled “Metas 2000” (i.e., translated Goals 2000) that allowed 50 teachers the opportunity to integrate technology resources in the classroom by pursuing a master degree in computational education. Her research study, titled “Medication Adherence among Older Adults: A Qualitative Descriptive Study”, a requirement for the degree of Doctor of Health Administration (DHA), provided the opportunity to interview elderly people, ages 65 to 80, in community centers to explore issues with medication adherence. Dr. Tricoche’s main interest includes working with research focusing on models to improve the health of the population.

Dr. Joann Kovacich

Faculty Member, Health Administration, On-line School of Advanced Studies, University of Phoenix, Phoenix, AZ, USA

Dr. Joann Kovacich is an on-line School of Advanced Studies, University of Phoenix faculty member. She has a BA in Cultural Anthropology and German from Kent State University in Ohio, a MA in Anthropology and Empirical Cultural Studies from Eberhard Karls Universitaet Tuebingen in Germany, and a PhD in Law, Policy and Society from Northeastern University in Massachusetts. As an applied medical anthropologist her areas of specialization include interdisciplinary health care delivery, alternative health care, aging, ethnicity, gender, health care policy and law, intergenerational relationships and informal and formal support systems. She has taught at several northeastern universities in the areas of anthropology, health care and professional development. As former Principle Investigator and Project Director of the DHHS funded Interdisciplinary Rural Health Care initiative in Maine, she developed online courses and co-produced an interactive training CD on aging for health care professionals. Serving as Director of Distance Education for the Harvard Geriatric Education Center, Harvard Medical School, she designed several self-study modules in the area of Alzheimer research, medication management, and transcultural communication. Funded by a NIH Small Business and Technology Grant, Dr. Kovacich is participating on a team to develop online evidence-based alternative health modules for palliative care.