ABSTRACT
<b>Objective:</b> Assistance from health professionals is very important to ensure medication adherence among older people. The present study aimed to assess the relationship between receipt of comprehensive medication management services by primary care physicians and medication adherence among community-dwelling older people in rural Japan.<b>Methods:</b> Data including medication adherence and whether or not a doctor knew all the kinds of medicines being taken were obtained from individuals aged 65 years or older who underwent an annual health checkup between February 2013 and March 2014 at a public clinic in Asakura. The subjects were divided into 2 groups: adherent (always) and non-adherent (not always). A logistic regression analysis was performed to assess the association between the presence of a doctor who was fully responsible for medication adherence and self-reported adherence. Predictors that exhibited significant association (<i>p-</i>value < 0.05) with medication adherence in a univariate analysis were entered in the model as possible confounding factors. The results were presented as odds ratios (OR) and 95% confidence intervals (CI).<b>Results:</b> Among four-hundred ninety-seven subjects in total, the adherent group included 430 subjects (86.5%), and its members were older than those of the non-adherent group. Significant predictors of good medication adherence included older age, no discomforting symptoms, eating regularly, diabetes mellitus and having a doctor who knew all the kinds of medicines being taken. After being adjusted for confounding variables, the subjects with a doctor who knew all the kinds of medicines they were taking were three times more likely to be adherent to medication (OR 3.01, 95% CI 1.44-6.99).<b>Conclusion:</b> Receipt of comprehensive medication management services for older people was associated with medication adherence.
ABSTRACT
<b>Background and Objective</b><BR> The prevalence of non-communicable diseases (NCD) is increasing in low- and middle-income countries, imposing major public health and development threats. However, there is difference among countries with regard to the patterns of NCD metabolic risk factors. This study aims to categorize the pattern of metabolic risk factors in East Asia, Southeast Asia and Oceania. <BR><b>Methods</b><BR> Age-standardized prevalence of obesity, raised blood pressure, raised blood glucose, and raised blood cholesterol for 2008 were obtained from the World Health Organization (WHO) Global Health Observatory Data Repository. We used hierarchical cluster analysis to categorize countries in East Asia, Southeast Asia and Oceania based on the prevalence of NCD metabolic risk factors of each country. <BR><b>Results</b><BR> Three patterns of NCD metabolic risk factors were identified. The first pattern showed relatively high prevalence of raised blood cholesterol, while prevalence of obesity, raised blood pressure and raised blood glucose remain relatively low. Most high- and upper-middle-income Asian countries were included in this pattern. The second pattern presented relatively high prevalence of raised blood pressure, although prevalence of obesity, raised blood glucose, and raised blood cholesterol stay relatively low. Most low- and lower-middle-income Asian countries were categorized in this pattern. The third pattern presented high prevalence of obesity and relatively high prevalence of raised blood pressure and raised blood glucose. This pattern included most Pacific island countries.<BR><b>Conclusions</b><BR> Policy makers in countries in East Asia, Southeast Asia, and Oceania should take into account for the features of the pattern they are in, when they set priorities for developing effective NCD control measures.