Preventive Care

Compliance/Health Care Utilization

Compliance or adherence is an important factor to be considered in elderly Asian Indians. The culturally specific factors that determine adherence in Asian Indian immigrant have not been studied, although they could be inferred from other studies aimed at racial or culture differences.

Li (2008) studied compliance in elderly Chinese immigrants points out that their length of stay in the U.S.A. and gender could play an important role in a treatment adherence (Li et al, 2008).

Some predictors of poor adherence in general population (Osterberg, 2005)

  • Having no insight into the illness process, and barriers
    to care or medications
  • Inadequate follow-up or unclear discharge planning
  • Side–effects of medications
  • Do not believe in the treatment process
  • Poor patient-doctor relationship
  • Complexity of the treatment
  • Cost of medication, co-payment or both
  • Presence of Depression, cognitive impairment,
    asymptomatic disease

Possible barriers to adherence (Osterberg, 2005)

  • The patients does not understand the disease process and about the necessity of undergoing treatment and the risks of forgoing medications or doses
  • Patients’ inability to follow complex treatment regimens
  • Does not understand the risks of improper
    use of medicine
  • Patients’ limited access to health care system clinics
    and pharmacy, high cost of medications
  • Physicians’ limited knowledge on cost of drugs
    and insurance coverage