Therapeutic Adherence and Potentially Inappropriate Prescribing in Older Adults with Polypharmacy in Primary Health Care

Purpose: Treatment adherence is essential for achieving therapeutic goals and improving patient outcomes. In older adults, polypharmacy and potentially inappropriate prescriptions (PIPs) may negatively affect adherence. Objective: To assess treatment adherence in older adults with polypharmacy and PIPs in a primary care setting. Patients and Methods: A descriptive, observational study was carried out in the primary care setting of Toledo, Spain, involving patients aged over 65 who had been taking six or more medications for at least six months. Demographic, clinical, and pharmacological data were collected. Adherence was the primary outcome. PIPs were assessed using the Beers and STOPP criteria. Data were obtained from electronic medical records, prescription systems, and billing records. Results: The study included 448 patients (mean age: 79 years; 60.9% female). A total of 4413 medications were prescribed, with a mean of 9.9 drugs per patient. Overall adherence was 64.3%. The prevalence of PIPs was 44.0% (STOPP) and 42.6% (Beers). No significant association was found between adherence and PIPs (p = 0.426 for Beers; p = 0.164 for STOPP). Conclusion: Among older adults with polypharmacy, treatment adherence was 64.3%. The rate of potentially inappropriate prescribing was high, but no significant relationship with adherence was observed. Further studies are needed to explore the impact of PIPs in this population. Pharmaceutical interventions-such as educational programmes for prescribers and patients, and regular medication reviews-may help improve adherence.