# 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.

## Key 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.