Prescription psychotherapeutic drug non-adherence (not taking drug as prescribed dose) is a significant public health concern. Older adults are frequently prescribed psychotherapeutic drugs including opioids (pain relievers) and central nervous system (CNS) depressants (tranquilizers and sedatives). Older adults are particularly susceptible to adverse medical outcomes from prescription drug abuse, as well as drug interactions due to age-related physiologic changes in body composition and drug metabolism. Negative consequences are even more adverse when older adults abuse more than one type of psychotherapeutic drug or simultaneously use psychotherapeutic drugs and alcohol. However, little is known about risk factors for prescription psychotherapeutic drug non-adherence and the combined use of prescription drug and alcohol. In addition, few screening tools related to drug abuse have been validated in this population. Findings of this study will lead to clinical recommendations for early identification of older adults who may be at risk for psychotherapeutic drugs non-adherence or abuse, relevant to the missions of the National Institute on Drug Abuse. The purpose of this study is to describe different patterns of adherence to prescription psychotherapeutic drugs and determine the risk factors of non-adherence among older adults.
The specific aims of this study are to: (1) examine the psychometric properties of the Timeline Follow Back (TLFB) measuring prescription drug adherence among older adults;(2) to describe patterns of adherence to prescription psychotherapeutic drug and combined use of psychotherapeutic drug and alcohol among older adults;and (3) identify risk factors of psychotherapeutic drug non-adherence among older adults. This ongoing study is a cross-sectional design. Eligibility criteria include older adults who are 65 or older, taking at least one type of prescription psychotherapeutic drug, and able to communicate. One hundred and fifty participants will be recruited for this study. Participants will be recruited from the outpatient clinics at the VA Western New York Health System (VAWHYHS), Buffalo VA, senior centers, and senior apartments. Instruments include demographic questionnaire, Timeline Followback (TLFB) measuring medication adherence and alcohol use, Drug Abuse Screening Test-10 (DAST-10), Medication Adherence Scale (MAS), Alcohol Use Disorder Identification Test (AUDIT), Cumulative Illness Rating Scale (CIRS), Mini Mental State Examination (MMSE), Perceived Health Status (SF-12), and Belief of Medication Questionnaire (BMQ). Descriptive and correlational statistics will be used for data analysis. Logistic regression will be performed to identify significant predictors of prescription drug non-adherence. This pilot study seeks to gain new insight regarding prescription drug non-adherence and the combined use of prescription drugs and alcohol, as well as contributing factors of non-adherence in older adults. This project initiates a program of research that will ultimately lead to the development of interventions for monitoring prescription drug adherence among older adults.

Public Health Relevance

Prescription psychotherapeutic drug non-adherence among older adults is a growing public health concern. Understanding how older adults adhere to these addictive medications will provide clinicians useful information to better identify older adults who may be at risk for harm related to their non-adherence to prescription drug regimens. Clinicians need to routinely screen medication-taking behaviors among older adults who are prescribed psychotherapeutic drug in order to practice prevention and early intervention.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Small Research Grants (R03)
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Special Emphasis Panel (ZRG1-IFCN-L (50))
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Obrien, Moira
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State University of New York at Buffalo
Schools of Nursing
United States
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