Analysis of the Current Situation and Influencing Factors of Medication Adherence among the Elderly in Shandong Province Under an Active Health Management Model postprint

Abstract: Background  The elderly often suffer from a variety of chronic diseases and require multiple drug treatments. However，many patients struggle to sustain or standardize their medication due to various factors，leading to poor disease control and unsatisfactory medical outcomes. Therefore，understanding the current status and influencing factors of medication adherence among the elderly is crucial for improving and enhancing their adherence. Shandong Province，one of the most populous provinces in China，is at the forefront of the country in terms of aging. The overall medication compliance among the elderly in Shandong is poor，characterized by frequent changes in medication timing，missed doses，or incorrect dosages. As a result，medication adherence among the elderly in Shandong has become a key factor affecting treatment efficacy and quality of life. Objective  This study aims to explore the medication adherence among elderly individuals in Shandong Province under the active health management model，and to analyze the factors influencing their medication adherence，thereby providing an effective reference for the management of medication behavior in this population. Methods  A total of 5 447 elderly individuals aged 65 and above were selected from 100 basic community units in Shandong Province using a multi-stage random sampling method. The survey content included basic sociodemographic information，health-related knowledge，health-related attitudes，health-related behaviors，medication adherence，and quality of life. The chi-square test was used to compare the scores of chronic disease knowledge，beliefs，behaviors and quality of life among the elderly. Multivariate Logistic regression analysis was employed to explore the factors influencing medication adherence in this population. Results  Among the 5 447 elderly individuals included in the study，the score on the Morisky scale was（6.33±1.31）. Of these，4 480（82.25%）had good medication adherence，while 967（17.75%）had poor adherence. Logistic regression analysis revealed that gender（OR=0.86，95%CI=0.74~0.99，P=0.038），marital status（OR=0.90，95%CI=0.82~0.98，P=0.017），health-related attitudes（OR=0.78，95%CI=0.68~0.90，P<0.001），willingness to change behavior（OR=0.51，95%CI=0.41~0.65，P<0.001），and quality of life（OR=0.66，95%CI=0.57~0.77，P<0.001）were significant factors influencing medication adherence among the elderly. Conclusion  The medication adherence of the elderly in Shandong Province is generally good. However，factors such as health related attitudes，willingness to change behavior，and quality of life significantly impact adherence. Therefore，these factors should be prioritized in the development of intervention strategies to improve medication adherence among the elderly.