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Aging and disease    2016, Vol. 7 Issue (3) : 246-253     DOI: 10.14336/AD.2015.0925
Original Article |
Predictors of Difficulty in Medication Intake in Europe: a Cross-country Analysis Based on SHARE
Figueiredo Daniela1,2, Teixeira Laetitia3, Poveda Veronica3, Paúl Constança3,4, Santos-Silva Alice5, Costa Elísio5
1University of Aveiro, School of Health Sciences, Aveiro, Portugal.
2Center for Health Technology and Services Research (CINTESIS.UA), Aveiro, Portugal.
3Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.
4CINTESIS, Center for Health Technology and Services Research (CINTESIS), Porto, Portugal.
5UCIBIO, REQUIMTE and Faculty of Pharmacy, University of Porto, Porto, Portugal.
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The aim of this study is to evaluate the prevalence and the predictors of difficulty in medication intake across Europe, using a cross-sectional design. We used data from all participants in the wave 4 of the SHARE (Survey of Health, Ageing, and Retirement in Europe) database, which is a cross national European survey. The difficulty in take medication was evaluated using an item from the “Limitations with activities of daily living”. Clinical and sociodemographic variables were evaluated as potential predictors. A total of 58 124 individual have been included in this work (mean age=64.9 ± 10.4 years; 43.3% male). The rate of difficulty in taking medication across the 16 European evaluated countries was 2.1%, presenting Spain the highest rate (5.7%) and Switzerland the lowest (0.6%). Increasing age, physical inactivity, physical limitations (mobility, arms function and fine motor limitations, and difficulties in picking up a small coin from a table), a poor sense of meaning in life, and losses in memory and concentration are independent and significant variables associated with difficulty in medication intake across Europe. Predictors of difficulties in medication intake are multicausal, including factors related to physical, cognitive and psychological conditions. Interventions aiming to optimize adherence to medication, particularly in elderly population, need to consider this diversity of determinants.

Keywords difficulty in take medication      elderly      SHARE      non-adherence      persistence     
Corresponding Authors: Costa Elísio   
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These authors equally contribute this work

Issue Date: 09 January 2016
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Figueiredo Daniela
Teixeira Laetitia
Poveda Veronica
Paúl Constança
Santos-Silva Alice
Costa Elísio
Cite this article:   
Figueiredo Daniela,Teixeira Laetitia,Poveda Veronica, et al. Predictors of Difficulty in Medication Intake in Europe: a Cross-country Analysis Based on SHARE[J]. Aging and disease, 2016, 7(3): 246-253.
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CountryAll individuals
Individuals with less than 65 years
Individuals with more than 65 years
Cases of difficulty in medication intake
All individuals
n (%)
Individuals with less than 65 years
n (%)
Individuals with more than 65 years
n (%)
Austria52412781245668 (1.3)8 (0.3)60 (2.4)
Germany157165391838 (2.4)3 (0.5)35 (3.8)
Sweden1946706124054 (2.8)1 (0.1)53 (4.3)
Netherlands27551503125226 (0.9)3 (0.2)23 (1.8)
Spain355516121943203 (5.7)30 (1.9)173 (8.9)
Italy35741736183895 (2.7)5 (0.3)90 (4.9)
France574731632581104 (1.8)16 (0.5)88 (3.4)
Denmark2269130696345 (2.0)4 (0.3)41 (4.3)
Switzerland37392052168721 (0.6)2 (0.1)19 (1.1)
Belgium527630862189108 (2.0)18 (0.6)90 (4.1)
Czechia607933562719100 (1.6)28 (0.8)72 (2.6)
Poland171794477264 (3.7)14 (1.5)50 (6.5)
Hungary30651773129153 (1.7)11 (0.6)4 (3.3)
Portugal2054115289846 (2.2)9 (0.8)37 (4.1)
Slovenia27411528121346 (1.7)13 (0.9)33 (2.7)
Estonia679532803515146 (2.1)26 (0.8)120 (3.4)
Total5812430440264491217 (2.1)191 (0.6)1026 (3.7)
Table 1  Distribution of the individuals from each country presenting difficulties in medication intake, and in accordance with age (less or more than 65 years).
nCases of difficulty in take medication
n (%)
ORCI 95%p
Difficulties in walking 100 meters
Yes6986846 (12.1)1--
No51125368 (0.7)0.0530.047-0.060<0.001
Difficulties in picking up a small coin from a table
Yes2528660 (26.1)1--
No55583554 (1.0)0.0430.038-0.049<0.001
How satisfied with life56843827 (1.5)0.7130.692-0.734<0.001
Life has meaning
Never1690127 (7.5)1--
Rarely4189190 (4.5)0.5790.458-0.731<0.001
Sometimes13248244 (1.8)0.2280.183-0.286<0.001
Often37407254 (0.7)0.0860.06-0.108<0.001
Future looks good
Never4754317 (6.7)1--
Rarely11034236 (2.1)0.2860.240-0.341<0.001
Sometimes20335170 (0.8)0.1080.089-0.131<0.001
Often2017187 (0.4)0.0550.043-0.071<0.001
How many meals a day576611086 (1.9)1.1031.026-1.1850.008
Poor3900470 (12.1)1--
Fair11396259 (2.3)0.1220.105-0.143<0.001
Good25322176 (0.7)0.0440.037-0.053<0.001
Very good1337037 (0.3)0.0200.015-0.029<0.001
Excellent332417 (0.5)0.0280.017-0.045<0.001
Highest educational degree obtained37758684 (1.8)1.0091.006-1.012<0.001
Female32931701 (2.1)1--
Male25193516 (2.0)0.9530.849-1.0690.411
Network satisfaction54707849 (1.6)0.9020.860-0.946<0.001
Received help from others
No31799348 (1.1)1--
Yes8119433 (5.3)5.5474.815-6.452<0.001
Given help last twelve months
No29472733 (2.5)1--
Yes1044650 (0.5)0.1960.147-0.262<0.001
Number of chronic diseases580741214 (2.1)1.5351.492-1.580<0.001
Mobility, arm function and fine motor limitations581111214 (2.1)1.7741.736-1.814<0.001
Physical inactivity
Never vigorous nor moderate physical activity7188778 (10.8)1--
Other50482312 (0.6)0.0540.047-0.062<0.001
Sleep (part of EURO-D)
Selected20697518 (2.5)1--
Not selected36634451 (1.2)0.4970.437-0.565<0.001
Interest (part of EURO-D)
Selected5356362 (6.8)1--
Not selected51909576 (1.1)0.1670.146-0.192<0.001
Concentration (part of EURO-D)
Selected10826661 (6.1)1--
Not selected46374287 (0.6)0.0980.085-0.112<0.001
Enjoyment (part of EURO-D)
Selected8115417 (5.1)1--
Not selected49135516 (1.1)0.1980.173-0.226
Depression scale EURO-D - high is depressed56527838 (1.5)1.4691.434-1.504<0.001
Age581071217 (2.1)1.1181.111-1.124<0.001
Table 2  Association of explanatory variables with difficulty in medication intake (unadjusted models)
nCases of difficulty in take medication
n (%)
ORCI 95%p
Difficulties in picking up a small coin from a table
Yes2528660 (26.1)1--
No55583554 (1.0)0.4410.376-0.517<0.005
Life has meaning
Never1690127 (7.5)1--
Rarely4189190 (4.5)0.8350.663-1.0510.125
Sometimes13248244 (1.8)0.7510.608-0.9270.008
Often37407254 (0.7)0.7810.636-0.9600.019
Poor3900470 (12.1)1--
Fair11396259 (2.3)0.5300.454-0.618<0.001
Good25322176 (0.7)0.5310.455-0.620<0.001
Very good1337037 (0.3)0.5460.456-0.654<0.001
Excellent332417 (0.5)0.5550.440-0.701<0.001
Mobility, arm function and fine motor limitations581111214 (2.1)1.0741.051-1.097<0.001
Physical inactivity
Never vigorous nor moderate physical activity7188778 (10.8)1--
Other50482312 (0.6)0.6660.588-0.755<0.001
Concentration (part of EURO-D)
Selected10826661 (6.1)1--
Not selected46374287 (0.6)0.8220.736-0.918<0.001
Age581071217 (2.1)1.0051.001-1.0100.023
Table 3  Association of explanatory variables with difficulty in medication intake (adjusted model)
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