As the aging population continues to increase, there has been a rise in the prevalence of multimorbidity in the elderly. The adherence to medication regimens by elderly patients with multimorbidity significantly impacts the effectiveness of chronic disease management.

This study analyses the factors that impact medication adherence among the elderly with multimorbidity in Guangdong province. This study aims to provide a foundation for the management of multimorbidity in this population.

A multi-stage stratified cluster random sampling method was used to survey a population of 998 multimorbid patients aged 60 years and above in Guangdong province from October 2022 to March 2023. Medication adherence was the dependent variable, while patient sex, age, marital status, living conditions, education level, personal annual income, family encouragement for medication adherence, family doctor support, number of diseases, disease awareness, medication awareness, BMI, smoking and alcohol consumption were considered as independent variables. Multivariate Logistic regression analysis was used to identify the factors influencing medication adherence among elderly patients with multimorbidity in Guangdong province.

A total of 1 000 questionnaires were distributed and 998 valid questionnaires were collected, with a valid recovery rate of 99.8%. Among the 998 cases of elderly patients with multimorbidity in Guangdong province, there were 719 cases (72.0%) with good adherence to medication and 279 cases (28.0%) with poor medication adherence; there were 512 cases (51.3%) of males and 486 cases (48.7%) of females. The results of multivariate Logistic regression analysis showed that: education level (high school/secondary school: OR=0.298, 95%CI=0.117-0.762; college and above: OR=0.325, 95%CI=0.127-0.831), personal annual income (>30 000 to 50 000 yuan: OR=7.694, 95%CI=2.071-28.582; >50 000 to 100 000 yuan: OR=12.408, 95%CI=3.229-47.686; >100 000 to 200 000 yuan: OR=4.893, 95%CI=1.174-20.397), and frequency of family members' supervision of medication taking (occasionally: OR=1.842, 95%CI=1.222-2.779), family doctor's help (slightly helpful: OR=2.537, 95%CI=1.531-4.205), understanding of the condition (mostly understood: OR=3.015, 95%CI=1.948-4.667; better understood: OR=3.510, 95%CI=1.955-6.300; some/no understanding: OR=3.469, 95%CI=1.338-8.994), medication concern (mostly concerned: OR=4.928, 95%CI=3.336-7.278; more concerned: OR=3.670, 95%CI=1.915-7.033; somewhat concerned/unconcerned: OR=8.560, 95%CI=2.497-29.339), BMI (too low: OR=2.303, 95%CI=1.154-4.598; overweight/obese: OR=0.598, 95%CI=0.390-0.915), and alcohol consumption (OR=1.959, 95%CI=1.270-3.022) were the influencing factors of medication adherence among elderly patients with multimorbidity in Guangdong province (P<0.05) .

The elderly patients with multimorbidity in Guangdong province had better medication adherence, at 72.0%. Medication adherence was poorer among the elderly patients with multimorbidity in Guangdong province who were high-income earners, occasionally urged to take medication by their family members, slightly assisted by their family doctors, had a low understanding of their condition, paid little attention to the use of medication, had a low BMI, and drank alcohol. All parties in society should join hands to take multiple measures to improve the medication adherence of elderly patients with multimorbidity in all aspects, strengthen the integrated management of multimorbidity, and promote the health of elderly patients.

随着老龄化程度的加剧，慢性病共病患者在老年群体中出现的比例越来越高，慢性病共病患者能否严格遵医嘱服药影响着共病管理的效果。

调查广东省老年共病患者服药依从性，并分析其影响因素，为老年共病患者的共病管理提供依据。

2022年10月—2023年3月，采取多阶段分层整群随机抽样方法从广东省27个社区抽取998例60岁及以上共病患者进行调查。利用社区全科门诊、居民集中座谈的形式对共病患者进行面对面的询问方式完成匿名问卷调查。以服药依从性为因变量，以患者性别、年龄、婚姻状况、居住状况、文化程度、个人年收入、家人督促服药、家庭医生帮助、患病数量、病情了解度、药物关注度、BMI、吸烟、饮酒作为自变量，采用多因素Logistic回归模型分析广东省老年共病患者服药依从性的影响因素。

本次调查共发放1 000份问卷，回收有效问卷998份，有效回收率为99.8%。在998例广东省老年共病患者中，服药依从性好719例（72.0%），服药依从性差279例（28.0%）；男性512例（51.3%），女性486例（48.7%）。多因素Logistic回归分析结果显示：文化程度（高中/中专：OR=0.298，95%CI=0.117~0.762；大专及以上：OR=0.325，95%CI=0.127~0.831）、个人年收入（>3万~5万元：OR=7.694，95%CI=2.071~28.582；>5万~10万元：OR=12.408，95%CI=3.229~47.686；>10万~20万元：OR=4.893，95%CI=1.174~20.397）、家人督促服药频率（偶尔：OR=1.842，95%CI=1.222~2.779）、家庭医生帮助（略有帮助：OR=2.537，95%CI=1.531~4.205）、病情了解度（大部分了解：OR=3.015，95%CI=1.948~4.667；比较了解：OR=3.510，95%CI=1.955~6.300；了解一些/不了解：OR=3.469，95%CI=1.338~8.994）、药物关注度（大部分关注：OR=4.928，95%CI=3.336~7.278；比较关注：OR=3.670，95%CI=1.915~7.033；关注一些/不关注：OR=8.560，95%CI=2.497~29.339）、BMI（过低：OR=2.303，95%CI=1.154~4.598；超重/肥胖：OR=0.598，95%CI=0.390~0.915）、饮酒（OR=1.959，95%CI=1.270~3.022）是广东省老年共病患者服药依从性的影响因素（P<0.05）。

广东省老年共病患者服药依从性较好，为72.0%。高收入人群、家人偶尔督促服药、家庭医生略有帮助、病情了解度低、药物关注度低、BMI过低、饮酒的广东省老年共病患者的服药依从性较差。社会各方应联合采取多种措施，全方位提升老年共病患者的服药依从性，加强共病的整合管理，促进老年患者健康水平。