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Abstract

Adherence to antihypertensive medication is critical factor to control blood pressure and prevent complications in the patients with hypertension. Medication management requires cognitive ability such as attention and working memory and cognitive impairment can negatively affect medication adherence. In this study, we investigated the association of cognitive function and antihypertensive medication adherence among the elderly hypertensive patients in Korea. This retrospective cohort study was conducted by using the Korean National Health Insurance Service-National Sample Cohort Data of the Elderly. Study population included the elderly who took the National Life-Transition Health Examination in 2007 and 2008. Cognitive function was screened by Pre-screening Korean Dementia Screening Questionnaire (KDSQ-P). A cut off score of 4 or more are subjective to further dementia screening test. Medication adherence of antihypertensive medications was calculated based on prescription data and the cut-off values for appropriate adherence was 80%. Multivariate logistic regression analysis was conducted to analyse association between cognitive function and medication compliance, adjusting for sex, income level, residential area, comorbidities, and level of depression. A total of 20,303 elderly patients with hypertension were included in the study. The prevalence of poor medication adherence of antihypertensive medications among the elderly patients was 16.5%. Lower cognitive function was associated with poor medication adherence (Adjusted odds ratio 0.980, 95% CI 0.961-0.999 per score). Patients with cognitive impairment are a vulnerable group to poor medication adherence. Clinicians involved in the geriatric care should evaluate the cognitive function of the elderly thoroughly and make more efforts to educate patients with cognitive impairment and their caregivers about the significant risk associated with inappropriate adherence. Further studies investigating the reasons for non-adherence are needed in order to establish effective interventions for improving medication adherence.

Biography

Mi Hee Cho graduated from School of Material Science & Engineering, Purdue University, USA with PhD degree. Later, she started studying at School of Medicine, Pusan National University, Republic of Korea and graduated as Medical Doctor. After graduation from the medical school, she completed her residency with the specialty of Family Medicine and presently has been working as a Fellow at Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.