Treatment Adherence and Its Determinants in the Geriatric Population With Non-communicable Diseases Living in Urban Slums of Pune: An Analytical Cross-Sectional Study

TL;DR

This study examines medication adherence among elderly people with non-communicable diseases in urban slums of Pune and finds that socioeconomic factors are key barriers.

Contribution

The study identifies household head occupation and socioeconomic status as significant predictors of treatment adherence in geriatric NCD patients in urban slums.

Findings

80.3% of participants showed good medication adherence, while 19.7% showed poor adherence.

Poor adherence was significantly associated with the occupation of the household head and non-working status.

Low awareness and poor socioeconomic status were the major barriers to treatment adherence.

Abstract

Background/Purpose: Treatment adherence is crucial for managing noncommunicable diseases (NCDs), improving quality of life, and preventing complications, especially among the geriatric population. It remains a significant challenge in urban slums where out-of-pocket expenses contribute to non-adherence; hence, this study aims to assess treatment adherence.

Methods: Under the field practice area of a UHTC (urban health training center), a cross-sectional analytical study was conducted in the slums. A two-stage sampling method was used to select study participants, consisting of geriatric population individuals aged 60 years. Data was collected with the help of a questionnaire. To assess medication adherence, the General Medication Adherence Scale (GMAS) was used. Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 29 (Released 2024; IBM Corp., Armonk, New York, United States). The associations were calculated using odds ratios (ORs) and 95% confidence intervals (CIs).

Results: A total of 122 participants were included, comprising 69 (56.6%) female patients and 53 (43.4%) male patients, with 78 (63.9%) residing in joint families. The most common NCDs were type 2 diabetes mellitus (45.9%) and hypertension (39.3%). Overall, 80.3% demonstrated good adherence, while 19.7% showed poor adherence. Poor adherence was significantly associated with the occupation of the household head (OR = 3.97; 95% CI: 1.56-10.08; p = 0.003), and non-working participants also had higher odds (OR = 4.40; 95% CI: 0.97-19.96; p = 0.054). Lifestyle factors such as diet, exercise, and tobacco or alcohol use were not significantly associated. Major barriers included low awareness (42.6%) and poor socioeconomic status (38.5%).

Conclusion: This study among the geriatric population observed high medication adherence. It is essential to raise awareness about NCD management. Addressing barriers can significantly increase treatment adherence.