A mixed-methods study of the experiences and beliefs of older people with complex health care needs about medication adherence

Background: Medication adherence is seldom examined in older people from diverse ethnic, cultural, and language backgrounds. Purpose: The purpose of this study was to explore medication adherence among culturally diverse older people with complex health care needs. Methods: Using a mixed-methods design, a consecutive sample of 40 older people living in a culturally diverse, low socioeconomic area completed the Brief Medication Questionnaire; 12 reporting high medication nonadherence were interviewed. Analyses used descriptive statistics and thematic analyses. Results: Participants experienced high medication nonadherence (n = 34, 85%), language barriers (n = 15, 37.5%), financial difficulties (n = 24, 60%), and poor understanding of their medications (n = 34, 85%). Medication nonadherence was attributed to finger dexterity (57.5%), poor vision (85%), and memory problems (87.5%). Interviews revealed 5 themes to explain nonadherence: (1) illness beliefs; (2) experiences of the aging process; (3) challenges for non-English-speaking participants; (4) adherence impediments; and (5) therapeutic relationships. Conclusions: Vulnerable, older people had high medication nonadherence. Targeted interventions may enhance medication adherence in this group.