For Hardbound - GRP 3

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THE LEVEL OF DRUG COMPLIANCE OF THE SENIOR CITIZEN

OF KIPALILI, SAN ISIDRO, DAVAO DEL NORTE
A Research
Presented to the Faculty of Pharmacy
Tagum Doctors College, Inc.
Tagum City
In Partial Fulfillment
of the requirements for the Degree of
Bachelor of Science in Pharmacy
ARENDAIN, JHEN MEI L.

SUELLO, XYNTHEA LEI D.
LAMSIN, LENEAH JEANNETH M.
MAY 2021
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APPROVAL SHEET
This thesis entitled “THE LEVEL OF DRUG COMPLIANCE OF THE SENIOR
CITIZENS OF KIPALILI, SAND ISIDRO, DAVAO DEL NORTE” prepared by
JHEN MEI L. ARENDAIN, LENEAH JEANNETH M. LAMSIN and XYNTHEA
LEI D. SUELLO in partial fulfillment of the requirements for the degree of
Bachelor of Science in Pharmacy has been examined, approved and endorsed.
NEVIA SHEENA B. MARANAN, RPh, MSPharm
Adviser
PANEL OF EXAMINERS
APPROVED by the Research Committee on the Oral Examination with a grade
of PASSED.
ROSA VIENNA J. ILOG, RPh, MSPharm
Chairperson
MA. LEILANI A. BETONIO, RPh, MSPharm JESA S. MADELO,RPh, PhD
Member Member
ACCEPTED and APPROVED in partial fulfillment of the requirements for the
degree of Bachelor of Science in Pharmacy.
ROSA VIENNA J. ILOG, RPh, MSPharm
Dean of Pharmacy
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ACKNOWLEDGEMENT
This research would not have been possible without the assistance and
presence of the people listed below, who worked tirelessly to create and
complete this study. Thank you to everyone who believes and encourages us
in this research.
To our research adviser, Nevia Sheena B. Maranan, RPh, MsPharm,
who has been a constant source of encouragement and support for us
throughout our research.
To our Dean, Rosa Vienna Ilog, RPh, MsPharm, and the rest of the
Department of Pharmacy, who worked tirelessly to ensure that the researchers
did their best and that we could conduct this study.
To the members of the panel, Mrs. Leilani Betonio, RPh, MsPharm,
and Jesa S. Madelo, RPh, PhD, for sharing their knowledge, time, support,
and constructive criticism to help us improve our research.
To the Barangay official and health workers of Kipalili, San Isidro,
Mrs. Arlene C. Velarde, and Emelita D. Arangis for assisting us in gathering
our data and for their unwavering support.
To Mr. Bong Magno, our statistician, for expanding his knowledge of
data interpretation and analysis in our research.,
To Ms. Rica M. Largo, our grammarian, for sharing her expertise by
checking and reviewing our research.

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To our families, who have contributed time, love, moral knowledge,
and financial support to this research.
Above all, the researchers thanked our Almighty Father for showering
us with His love, wisdom, and care, as well as for guiding us in making this
research a success.
J.M.LA
L.J.M.L
X.L.D.S
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ABSTRACT
This study aimed to determine and evaluate the level of drug compliance of Senior
Citizens in Kipalili San Isidro Davao del Norte. The researchers believed that the findings
of this study may serve as a baseline for future studies in the drug compliance of Senior
Citizens. The study was conducted through a quantitative descriptive research design
using Independent Samples T-Test and One-Way ANOVA Test. Both was utilized to
show the significant difference between the drug compliance and the demographic
characteristics of respondents. Participants were one hundred fifty-six (156) Senior
Citizens in Kipalili San Isidro Davao del Norte and were given a questionnaire by the
help of barangay official in Kipalili. Results shows that 19.2% of the respondents were
60-65 years of age, 32.7% were 66-70 years of age, 26.9% were 71-75 years of age and
21.2% were 79-80 years of age. In gender, female respondents had 57.1% and 42.9% of
male respondents in the sample population. In educational level, 60.9% were secondary
level, 25.6% were primary level, and 13.5% were tertiary level. The overall mean of
cognitive development, patient‘s knowledge, and patient-healthcare professional
relationship drug compliance factor was 3.753 labelled as high. The level of drug
compliance of Senior Citizens in Kipalili San Isidro Davao del Norte obtained a mean of
3.888 described as high. The drug compliance in terms of gender with p-value of 0.841,
age with p-value of 0.632, and educational level with a p-value of 0.529 which are all
greater than 0.005 level of significance, therefore indicates that the demographic profiles
had no significant difference on the drug compliance of the respondents.
Keywords: Drug Compliance, Senior Citizens, Cognitive Development, Patient’s
Knowledge and Patient-Healthcare Professional Relationship

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TABLE OF CONTENTS
TITLE PAGE i
ACKNOWLEDGEMENT ii
ABSTRACT iii
TABLE OF CONTENTS v
LIST OF TABLES vii
LIST OF FIGURES viii
Chapter I PROBLEM AND ITS SETTING
Background of the Study 1
Statement of the Problem 4
Significance of the Study 5
Hypothesis 6
Theoretical Framework 6
Conceptual Framework 7
Scope and Limitation 9
Definition of Terms 9
Review of Related Literature 10

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Chapter II METHODOLOGY
Place of the Study 21
Sample and Sampling Technique 23
Research Design 23
Research Respondents 24
Research Instrument 24
Data Collection 25
Statistical Tool 25
Ethical Consideration 26
CHAPTER III: RESULTS AND DISCUSSION
CHAPTER IV: SUMMARY, CONCLUSION, AND RECOMMENDATION
Summary of Findings 41
Conclusion 44
Recommendation 46
REFERENCES 47
APPENDICES 53
A. Letter to Conduct the Study

B. Consent to the Barangay Captain
C. Informed Consent
D. Questionnaire
E. The demographic Profile of the Respondens in Terms of Age,
Gender and Educational Level
F.
CURRICULUM VITAE 72
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LIST OF TABLES
Table Page
1. Demographic Profile of the Respondents 30
2. Level of Factors Influencing Drug Compliance in Cognitive 32
And Psychomotor Development
3. Level of Factors Influencing Drug Compliance in Patient‘s 33
Knowledge
4. Level of Factors Influencing Drug Compliance in Patient - 34
Healthcare Professional Relationship
5. Level of Drug Compliance of Senior Citizen in Kipalili 36
San Isidro, Davao del Norte.
6. One-Way ANOVA Test for Age and Drug Compliance 37
7. Independent Samples T-Test for Gender and Drug Compliance 38
8. One-Way ANOVA Test for Educational Level and 39
Drug Compliance
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LIST OF FIGURES
Figure PAGE
1 Conceptual framework 8
2 The Map of the Philippines and Kipalili San Isidro Davao del Norte 22
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Chapter I
PROBLEM AND ITS SETTING
In this chapter the researchers would discuss different sources of information
from books, journals, and studies which relates to the study. The literature that is
gathered in this chapter will be used as reference in order to conduct this research.
Background of the study
Poor drug compliance among older patients is a public health concern as it
resulted to having an adverse outcome, waste of medication and an increased healthcare
cost and worsening the disease with an increased mortality rate (Osterberg et al., 2005).
Numerous studies were done in many developed countries in assessing the problem and
prevalence of poor compliance in geriatric patients. According to the previous study
conducted by Giardini et al. on 2016 and Benjamin on 2012, that usually older people
experienced with greater morbidity having an increased in utilizing the medication and
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are prone to risk of noncompliance. The rates of drug compliance are about 38% to 57%
and reportedly to have an average rate of greater than 45% in older populations.
Globally, in year 2015 there are already 901 million people of age 60 or older
where mostly, the elderly patients lived in developing countries and the reported cases
were expected to be more than double by 2050 which can reach to 2.1 billion (20% of the
total population). In the same year there are already about 14% of elderly population
which is a 125 million over aged of 80 or older and expected to triple by 2050 which can
reach 434 million that is approximately 20% of the senior population (WHO, 2015 &
UNDESA, 2015). In the United States, the noncompliance becomes a huge problem
which directed to linked in increased morbidity and mortality that costs between $100
and 300 billion per year (Bosworth et al., 2011). Another study, presented a percentage of
their respondents showing a low therapeutic adherence of about 35.3 % and such
education, age, and marital status are of significant factors on the patient‘s compliance
(Shaimol et.al., 2014). The Philippines belongs to a low middle-income country that
spends about 3.84% of the Gross Domestic Product (GDP) on the healthcare and 54.3%
of health expenditures that paid out from the pocket (National Health Accounts, 2009).
On the study conducted by De Guzman et al., 2019 wherein they concluded that the most
essential factor to be considered on confined Filipino elderly are the patient education
(34.78%), number of drugs to be taken at a time (29.47%), as well as the nurse-patient
relationship (19.07%).
Drug compliance is an important determinant in achieving a successful treatment
of every patients. The patients who comply to their prescribed medications regularly are
more likely to enjoy better health outcomes, avoid complications, premature death, and
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the use of less emergency care and inpatient hospital services (Oman Med, 2011). Thus,
there are many interventions and new develop services that are being implemented such
as medication reviews, enhanced patient counselling, and medication management (Greer
N. et. Al., 2015). Building a trusted relationship between the patient and healthcare
professional as well as the healthcare system is very essential and a prerequisite on
complying the patient‘s medication and for the maximum health outcomes (Graham J.
et.al., 2015). Although, the per counseling was only done for a few minutes but this can
be enough for the target intervention to the patient, and it must engage to a motivated and
patient-centered way. The pharmacists and healthcare professionals might use a various
of methods to assess the patient‘s compliance including direct adherence measures such
as laboratory tests and indirect measures such as questionnaires, electronic monitoring
(Arnet I. et al., 2013).
The goal of the study was to determine the level of drug compliance among the
senior citizens in barangay Kipalili San Isidro Davao del Norte. Since this is a rural area,
the people specifically the senior citizens experienced hard time to visit hospitals or
clinics for check-ups and to buy their medicines in the pharmacy. This study aimed to be
beneficial for the senior citizens in Kipalili, San Isidro, Davao del Norte, to the future
researchers, pharmacists and other health care providers to the importance of drug
compliance.
The researchers planned to disseminate the result of the study in the community
especially to the senior citizens in Kipalili, San Isidro, Davao del Norte, health care
providers and municipal health office. The research outcome served as a baseline
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information about the importance of complying the prescribed medications provided an
in-depth insight regarding drug compliance
Statement of the Problem
The researchers aimed to determine and evaluate the level of drug compliance of
the senior citizens. Specifically, the researchers aim to answer the following research
questions.
1. What are the demographic characteristics of the respondents in terms of:
1.1 Age
1.2 Gender
1.3 Educational Level
2. What are the level of factors influencing the patient compliance of respondents in terms
of:
2.1 Cognitive development
2.2 Patient‘s Knowledge
2.3 Patient-healthcare Professional relationship
3. What is the level of drug compliance of the Senior Citizens in Kipalili San Isidro Davao
del Norte?
4. Is there a significant difference in the level of drug compliance of senior citizens when
grouped according to demographics?
Significance of the study

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The results of this study provide information on the level of drug compliance of
the senior citizens in barangay Kipalili, San Isidro, Davao del Norte. Specifically, the
results of this study were beneficial to the following:
Future researcher: This study provided baseline information to the future researchers
who will be interested on the similar study.
Local Government of Tagum City: The results of this study would be helpful to the city
health office in disseminating, creating, and improving the policy protocol regarding the
importance of drug compliance specifically to the senior citizens.
Pharmacists: This study would be helpful to the pharmacists to have an insight about the
level of compliance of the patients especially the senior citizens and in terms of providing
other ways of counseling to the patients in order to effectively inform the patient on their
drug therapy.
Public: To the public, this would impart knowledge regarding the importance of drug
compliance. This will also impart essential information about the factors that influenced
the senior citizens in not complying to their prescribed drug therapy.
Residents of Barangay Kipalili San Isidro Daval del Norte: The residents specifically
the senior citizens would benefit in terms of improving their compliance to their
prescribed drug therapy.
Peer Reviewers: This study would surely help and inspire peer reviewers to determine
whether to publish or reject a study by providing information, analysis and reviewing the
study of each other to ensure that the study is reliable, valid and significant.
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Null hypothesis
The null hypothesis is rejected which means that there is no significant
relationship between the drug compliance and the demographic profile.
Theoretical framework
This study was supported by M.D Murrey's (2014), a research study ('A
Conceptual Framework for Studying Drug Adherence in Older Adults') which claimed
that patients >60 years of age frequently have several chronic diseases that require
multiple medications. However even drugs with well-documented benefits are often not
taken as prescribed, complicating the willingness of older adults to stick to them for a
variety of reasons, such as raising the number of prescriptions, vision, hearing and failure
to understand.
This study was also assisted by Tushar and Jyothi's (2016) proposal that the level
of compliance was positively associated with the study subjects' education level and their
knowledge of the diseases and prescribed medications. In subjects living with partners or
families, subjects without any functional disability, subjects who had daily follow-up
visits and even subjects who did not suffer any adverse events, the average level of
compliance was higher.
This study was supported by Sabaté E. Review of Study. (2003) states that in
elderly people there are many risk factors for non-adherence, including patient factors
such as age, sex, level of education and cognitive status. Factors of medicine such as
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complicated medication regimes, patient-prescriber facts and factors of the healthcare
system such as pharmacy evaluation challenge and lack of follow-up checkup.
The geriatric population is more vulnerable to multiple chronic and recurring
diseases that may require multiple medications for chronic medication. In this age group,
poor compliance contributes for drug waste with higher healthcare costs and serious
worsening of the condition with illness or death. By enhancing drug compliance, much of
the human and economic costs associated with non-adherence can be avoided.
Conceptual framework
The diagram in figure 1 shows the relationship between the independent and
dependent variables. The independent variables of this study were Patient‘s knowledge,
Cognitive Development and Patient-Prescriber Relationship as factors that can influence
to the dependent variable. Level of patient compliance is the dependent variable which
measures the degree of the Patient‘s obedience to the physician or healthcare advice.
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Independent Variables Dependent Variable
Patient Compliance
 Cognitive Development
 Patient‘s knowledge Level of Drug
Compliance
 Patient-Healthcare
Relationship
Figure 1. Conceptual Framework of the Study

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Scope and Limitations
This study determined the level of drug compliance of Senior Citizens in Kipalili
San Isidro Davao del Norte. The study conducted using a validated survey questionnaire
prepared by the researchers. The selection of the respondents was limited to the senior
citizens aged 60 to 80, who takes drugs for their maintenance medication. In addition,
this study does not involve the types of prescribe regimen and the specific illness of the
respondents.
Definition of Terms
Significant terms in this study were defined to easily understand the meaning in
the study. These are the following.
Compliance – it is the conscious effort to use drugs in the manner prescribes, it is a
behavior of individual which follow the proper instructions of the prescriber and other
healthcare providers.
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Drug – is a medicine or other substance which has a physiological effect when ingested
or when taking with the patient.
Level – pertain as the measurements of how low or how high the drug compliance of the
respondents.
Senior Citizen – the main respondents of this study. Senior citizen usually takes more
medication taken or maintenance.
Review Related Literature
In this section the researchers discussed different information from books, journals, and
studies which relates to study. The literature gathered in this chapter will be used as
reference in order to conduct this research.
Drug Compliance
In the Oxford dictionary, compliance is defined as the practice of obeying rules or

requests made by people in authority (Inkster, 2015). In healthcare, the most commonly
used definition of compliance is ―patient‘s behaviors (in terms of taking medication,
following diets, or executing lifestyle changes) coincide with healthcare providers‘
recommendations for health and medical advice‖ (Sackett, 2015). Thus, therapeutic non-
compliance occurs when an individual‘s health-seeking or maintenance behavior lacks
congruence with the recommendations as prescribed by a healthcare provider. Other
similar terms have been used instead of compliance, and the meaning is more or less
identical. For example, the term adherence is often used interchangeably with
compliance. Adherence is defined as the ability and willingness to abide by a prescribed
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therapeutic regimen (Inkster, 2015). From the perspective of healthcare providers, drug
compliance is a major clinical issue for two reasons. Firstly, noncompliance could have a
major effect on outcomes and have a direct clinical consequence. Non-compliance is
directly associated with poor treatment outcomes in patients especially with those
patients who has diabetes, epilepsy, Acquired immunodeficiency syndrome, asthma,
tuberculosis, hypertension, and organ transplant (Sebate, 2015).
According to the study of Buck and Jing Jin, patients over 60 years old were more
likely to be always compliant with their medication than patients under 60 years old. It
was also suggested that patients‘ antidepressant drug compliance was positively related to
age over 60 years old (Sirey, 2001). The result is consistent with the conclusion from
another study. However, some studies found out that the advancing age affected
compliance among elderly people direction (Balbay, 2005). The study by Balbay et. al.
was carried out in a rural area in Turkey among patients with tuberculosis and found out
that younger patients were more compliant to the treatment than older patients. The
research stated that this might be the result of poor education and knowledge level of
older patient.
Cognitive development
The possible reasons of poor compliance among older patients is that elderly
patients may have problems in vision, hearing, and memory. Thus, they have more
difficulties in following therapy instructions due to cognitive impairment, disabilities and
problems in swallowing tablets or capsules, opening drug containers, or reading and
identifying the drug product (Cooper et. al. 2005). On the contrary, older people might
also have more concern about their health than younger patients, that‘s why older
patients‘ non-compliance is non-intentional in most cases. As a result, if they can get the
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necessary help from healthcare providers or family members, they may be more likely to
be compliant with therapies. (Jeste, 2003).
Also, for patients with some level of cognitive impairment such as the effects are
often significantly magnified. The medication side effects can also alter the cognition and
lead no problems with concentrating, confusion and memory loss, among other patients.
It can contribute to patients‘ tendency in forgetting to take the medications, wrong
dosage, medication at the right time and other management shortcomings. As Mayo
Clinic notes stated ―your brain undergoes changes as you age that have minor effects on
your memory and thinking skills.‖ (Ross MD, 2020).
Elderly patients may have problems in vision, hearing, memory that may cause
more difficulties in following therapy instructions due to cognitive impairment or other
physical difficulties such as having trouble in swallowing tablets, opening drug
containers, handling small tablets, or identifying markings on drugs (Stewart, 2017). On
the contrary, older people may more concern about their health than younger patients. So
that older patients‘ drug compliance or non-compliance is non-intentional in most cases.
As a result, if they can get the necessary help from health care providers or family
members, they may more likely to complaint to therapy (Cooper et al, 2015).
In Japan, patients with the age of 40-59 years old were found less likely to be
complaint to their drug or medication. Also, young patients under 40 years were also
most likely to have a low drug compliance rate. In Singapore, patients with the age of less
than 3o years old were discover to be less likely to collect the medications prescribed
polyclinic that may lead to drug non-compliance (Lihara, 2014).

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Drug compliance is a complex behavior that can be influence by the patient‘s
belief, knowledge, age, patients-prescriber relationship and the methods by which
patients try to remember to take their medications. Evidence has shown that the cognitive
and memory loss may contribute in medication adherence as stated by Evanglista (2010).
The study of Park et. al. (2016) about drug compliance in patients with
rheumatoid arthritis, stated that study, older patients have higher levels of drug
compliance compared with the young patients who are busy and having erratic schedules
that interferes with remembering to take their medications. Thus, it‘s not age itself has a
negative impact on drug compliance, but rather other variables that include patient‘s
motivation and understanding as well as their cognitive and memory status. Older adults
who have mild to moderate cognitive impairment may have significant insight to the
potential implications of not taking their medication.
Age
Increasingly polypharmacy in elderly patient is a problem in the health care of
polymorbid and elderly people and affects morbidity and mortality. However, when
addressing polypharmacy, we should take into account that several chronic diseases
require different treatments or more than one drug in order to achieve therapeutic goals.
Nevertheless, it has been shown that polypharmacy increased the risk of adverse drug
reactions, drug-drug and drug-disease interactions. On the other hand, polypharmacy can
increase the risk of medication noncompliance, which can cause suboptimal therapeutic
effectiveness and poor clinical response (Nobili, 2011).

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According to Suzman (2011) one of the greatest achievements of the mankind in
the last century was the increase of life expectancy due to advances in public health,
technology and medicine. While in the twentieth century is the population of growth, the
twenty-first century will be known as the century of aging. Globally, in 2015, there were
901 million of people who were celebrating their 60 th birthdays or older, most of it are
elderly living in the developing countries. This number is expected to double up in the
year 2050, reaching 2.1 billion (20% total of the population). The number of people aged
by 80 or older is growing even faster than the elderly in general (Costa et al 2018). Aging
is characterized by changes in physical appearance such as gradual reduction height and
weight, higher reaction time, memory loss, reduced metabolic rate and a decline in
olfactory, vision and auditory functions (Giardini et al, 2017). Although the increase of
average life expectancy is worthy to celebrate health care providers must also need to
focus on the consequences not only for the health but also for the health system and
economy too because there are health conditions associated with the increase in the
elderly population. Cardiovascular disease is the most common risk that cause major
death among elderly patient along with these diseases, cancer is the other major cause of
mortality, being responsible for 12% deaths. Usually, older patients have multiple
problems. Among 50% of the elderly population has at least three chronic disease and of
this, approximately 10% has five or more. Aging and comorbidities together increase the
risk of hospitalization and mortality that may lead to non-adherence to their medication
(Midao et al, 2017).
The elderly people will require more health services, suffer more hospitalizations
and occupy the bed longer than other age group and due to the need for multiple drug
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therapy with complex medication regime, increasing cost of therapy, adverse effects,
drug interactions, forgetfulness, lack of familial and social support care, elderly patient
may not fully compliant to long term medications (Tushar et al 2016).
The main way to treat chronic illnesses is through medicine even though it is
powerful tool, its potential is not fully used since half of the patients do not take them as
prescribed, meaning they either do not take them or they do take them but in wrong
dosage form, time, and route of administration (Meditto, 2016). That contributes as a
major caused of morbidity, mortality, and health care costs. It is estimated between 20
and 50% of prescribed medication, depending on the disease and health care system, is
not taken directed. The majority of the studies showed that age was related to
compliance, however a few researchers found causing non-compliance (Wild et. al. 2016)
but from the review of articles showing correlation between age and drug compliance, it
would appear that the effect of age could be divided into three major groups: elderly
group which is over 55 years old, the middle age group which ranging from 40 to 54
years old and the young group 40 years old. Poor drug compliance also occurs in
adolescents and children with disease because young children need more help from their
parents to implement treatment. Therefore, their poorer drug compliance may be due to
lack understanding because of their age that could therefore influence their drug
compliance.
As stated by Cooper (2016) the problem of polypharmacy and drug compliance
in elderly living at home was common in such populations. Patients with chronic disease
can quickly become patient‘s polypharmacy and having problems in drug compliance.
Often, the drug which is good for one disease may not be good for the other.
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Patient Knowledge
The patient‘s knowledge about their disease and treatment is not adequate. Some
patients are lack with understanding of the role of their treatment (Ponnusakar et. al.
2004). Others lack knowledge about the disease and consequences of poor compliance or
lack of understanding with the value of clinic (Lawson et al 2005). Some patients thought
the need for medication was not continuous, so they tend to stop their medication to see
whether it is still needed (Vic et al 2005). For that reason, patient‘s knowledge and
education is very important to enhance compliance. Counseling about medications is very
useful in improving patient‘s compliance. Health care professional should give patients
enough education about the medications, treatment and disease (Seo et al 2005).
However, education is not always the ―the more the better‖ a relationship between
knowledge and compliance existed in adolescence. Adolescent who knows about their
therapies and drug were good compliers, while patients who knew little about their
therapies and drugs shows poor compliance (Hambur and Inoff 2006). In addition, the
content of education is crucial. Rubin (2005) found that educating the patients about their
disease state and general comprehension of medications would increase their active
precipitation in the treatment. Making sure patients understand the drug dosing regimen
could also improve patient compliance (Olubodun et al 2015). To make sure that the
patients remember what was taught, written instruction was identified to work better than
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verbal ones in explain thoroughly the things to be done, as patients often forget
physician‘s advice and statement easily (Tebbi 2000).
Several studies found that patient with high knowledge and education might have
higher compliance (Yavuz et al 2004). Intuitively, it may be expected that patients with
higher educational level should have better knowledge about the therapies and disease
and therefore be more compliance, however, researchers also found that even highly
educated patients may not understand their medication regimen (Dimatteo 2000). Other
researchers showed that the patients with lower education level have better compliance
according to Senior et al (2004).
According to the study of Hughes (2009), patients with hypertension having less
knowledge about the disease that are not related to hypertension (eg. Asthma) were less
likely to comply to their medication or antihypertensive therapy. Educating patients,
therefore, so that they can understand the deep potential risk about their disease and state
could possibly help to minimize unwanted productive health beliefs and promote
motivation to adhere to treatment.
Barriers to the effective drug compliance and use of medicines specifically
include poor and inadequate knowledge about the drug and its use, not being convince of
its use and of the need for the treatment (Kannel, 2014). It has also been observed that
those patients who gather wrong beliefs and inadequate health knowledge or a negative
relationship with the healthcare provider would cause noncompliance to their drugs and
medications (Mishra et al, 2015)

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Knowledge about the effects, indication and purpose of the medication positively
correlated to drug compliance. Pharmacist counseling plays the vital role in preventing
drug noncompliance and in making health care more effective. Hence, it is important for
pharmacist to cooperate not just to the patient but also to their other coworkers, including
the physician to provide written information on prescription medicine to caregivers as
well as to elderly patients (Okuno, 2015).
Another study of Wright et al (2010) reported that drug compliance was
significantly high within the group with an occasional financial level. A study of
Hernshaw et al (2014) reported that inadequate patient education influenced medication
compliance in older patients. Another study of Park et al. (2010) reported that drug
compliance was significantly lower in patients with a moderate instead of lower financial
status. In the current study, a significantly higher percentage of the drug compliance
group could name their drugs and will also mention indication, dosage, timing and
duration of its use. A study of elderly patients‘ compliance to their drug and their medical
knowledge reported that knowledge about the result and purpose of the medication were
positively correlated with drug compliance.
In the study of Rahman et. al. (2017) suggests that family, physicians and other
healthcare provider should improve their current education practices about medications
and private communication skills to extend patients‘ knowledge about their medications,
which successively enhances drug compliance among elderly patients. Identifying
specific barriers for every elderly patient, especially their satisfaction regarding their
medications, and adopting suitable techniques to beat them especially family member‘s
involvement are going to be necessary to enhance drug compliance.

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Patient-healthcare professional relationship
A healthy relationship is based on patient‘s trust in prescribers and empathy from
the prescribers. Studies found that compliance is good when prescribers are emotionally
supportive, giving reassurance or respect, and treating patients as an equal partner
(Lawson et al 2005). Researcher mentioned some situations that may influence patients‘
trust in physician (Rubin 2005). For example, physician who asked few questions and
doesn‘t made eye contact with patient and patients who found difficulty in understanding
the physician‘s language or writing and too little time spent with the patients was likely
to discourage the patient‘s motivation in the therapy and treatment (Lawson et al 2005).
Poor communication with the patient can cause negative effect on patients‘
‗compliance. Lim and Ngah (2016) showed in their studies that non complaint
hypertension patients felt the doctor‘s lack of concern for their problems. In addition,
health care providers prescribing might decrease patient‘s confidence in the prescribe
treatment (Vlasnik et al 2005).
According to Hughes (2009), patients with hypertension who gave lower priority
to discuss their disease to the physician were significantly more likely to be
noncompliance to their antihypertensive therapy. This suggest to improve patient-
prescriber relationship is a key for future research potentially improve patient‘s drug-
compliance. Furthermore, this study identified potential logistical barriers to successful
compliance with the medication use process.
The patient-prescriber relationship is essential to the delivery of primary
healthcare. In any consultation several aspects of the physician-patient relationship may

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affect the result, including longitudinal relationship between physician patient,
agreement, need and its management, patients‘ trust toward their physician to act their
best interest and the ability of the physician to enable the patient toward effective self-
care and drug compliance (Connel, 2016). Patients are less likely to return to their
physician when there is lack of physician-patient concordance, although, the relationship
is inconsistent. Trust is said to be the essential to the medical consultation and is related
to continuity and patient satisfaction (Gray, 2015). The ability of the physician to help the
patient towards their effective self-care and drug compliance is a marker of consultation
standard as stated by Maxwell (2015).
As researched by Mainous et. al. (2016), indicates that drug compliance of the
patients is positively related to patient-prescriber relationship and their findings suggest
that efforts in building a relationship between the physician and patient may improve
primary care outcomes and ensures that the patient understand the physician, patient‘s
problem, and that management is acceptable will require excellent communication skills,
especially listening skills. These skills could be the factor to help patients in drug
compliance (Turner, 2017).

21
Chapter II
METHODOLOGY
This chapter deals with the methods and procedures that would be used in
gathering the necessary data to conduct this study. The researcher presented the process
of how the necessary data and information will be obtain, collected, presented, and
analyzed through research design, sampling procedure and sample size, validation of the
survey questionnaire, data collection and statistical analysis.
Place of the Study
The barangay Kipalili of San Isidro, Davao del Norte, Philippines was a
macrohabitat with the presence of dominant physical features, terrestrial grass land
habitat and its topography is a low land area surrounded by hills. The coordinates of the
site were measured by Global Positioning System (GPS) with a coordinate of 7° 45‘
North, 125° 44' East (7.7467, 125.7275). The Barangay Kipalili, San Isdro, Davao del
Norte has a population of 3056 people, including 257 senior citizens.

22
Figure 2: The Map of the Philippines and Kipalili San Isidro Davao del Norte
23
Sampling and Sampling Technique
The senior citizen living in barangay Kipalili, San Isidro, Davao del Norte
were the respondents and were identified using simple random sampling. Sample size
population were from the list of Senior Citizens in barangay Kipalili. Sample size of the
respondents was determined using Slovin‘s Formula at 95% confidence level and 5%
margin of error.
Research Design
This study utilized quantitative descriptive method. The independent variable
were cognitive development, patient‘s knowledge, and patient-healthcare professional
relationship, while the dependent variable was the level of the drug compliance. The
adapted survey questionnaire was an instrument used in this study to determine the level
of the drug compliance of the senior citizens of barangay Kipalili, San Isidro, Davao del
Norte. The adapted questionnaires were administered to the selected residents of

24
barangay Kipalili using simple random sampling technique. After the data gathered, the
researchers compiled and summarized the results.
Research Respondents
The respondents of this study were senior citizen who are identified based on the
latest list provided dated year 2020 in the residents of Barangay Kipalili, San Isidro,
Davao del Norte. The total number of senior citizens were 257, with 141 females and 116
males. The total sample size of 156 respondents was randomly selected using the Slovin‘s
Formula. This respondent age range is between 60 – 80 years old. The study was
conducted to the respondents by tapping a barangay official, then the relatives of the
respondents were also asked in time of need.
Research Instrument
The researchers prepared an adapted survey questionnaire, checked, and reviewed
by the research panel committee including the thesis adviser. The items included in the
questionnaire are develop according to objectives and purpose of the study. The
questionnaire was translated in Bisaya (the respondent‘s native language) for easy
25
comprehension and better understanding. The questionnaire was made in simple, brief,
and concise form to provide a basic understanding for senior citizen. The survey
questionnaire included five questions for independent and dependent variables,
respectively. The survey questionnaire consisted of questions that uses 5point Likert scale
- a type of psychometric response scale in which responders specify their level of
agreement to a statement typically in five points: (1) Strongly disagree; (2) Disagree; (3)
Neither agree nor disagree; (4) Agree; (5) Strongly agree.
Data Collection
The adapted survey questionnaires were be distributed to the randomly selected
senior citizens residents of barangay Kipalili, San Isidro, Davao del Norte. First, the
researcher got approval from the Barangay captain of Kipalili to conduct the study in
their barangay. When he consented, he enlisted the assistance of some barangay officials
to assist us in gathering our data, and the researcher ensured that they understood the
study by giving them a brief introduction and discussing our research. The researchers
ensured that the barangay officials took precautions by providing them with what they
needed, such as alcohol, masks, and face shields, as well as reminding them to wash their
hands on a regular basis, wear protective personal equipment, and observe social
distancing. The researchers and barangay officials agreed that every day, they would
26
place fully completed questionnaires on the barangay hall, and the researchers would
collect and gather the data.
Statistical Tool
The gathered data was tabulated and analyzed using the statistical tools below:
Mean. This was used to determine the level of drug compliance of the senior
citizen of the barangay Kipalili, San Isidro, Davao del Norte.
Standard Deviation. This was used to tell how measurements for a group are
spread out from the average mean.
Independent Samples T-Test. Parametric test that was used to compare the
means of two independent variables the drug compliance and gender, in order to
determine whether there was significantly different between the two variables.
One – Way ANOVA. This was used to determine if there are statistically
significant differences between the drug compliance and age and educational level.
Ethical Consideration
Ethical considerations in research were critical and crucial. The integrity,
reliability and validity of the research findings rely heavily on adherence to ethical
27
principles. Thus, the researchers ensured the safety, confidentiality, and provided full
protection to the participants. The ethical principles of autonomy, informed consent,
privacy and confidentiality, justice, transparency, and vulnerability of the participants
were guides for the researchers to address the initial and ongoing tensions between the
needs and goals of the research and the rights of participants.
The main ethical principles that were considered in conducting this research study
are the following:
Autonomy. Researchers would respect the participant‘s decision on whether to
participate the study. Th research participants were provided with complete information
about the study, and it is the researcher‘s obligation not to exploit the weaknesses of the
participants.
Informed consent. The researcher makes sure that the participants were informed
of the purpose of the study. Written consent is provided for them to get their approval.
Moreover, the participants ensured that they understand all the aspects of the study. They
would not be forced to participate if they would not be willing to join.
Privacy and confidentiality. The researcher guarantees that the participants‘
identity was protected and were not divulged to any third parties. Any results of the
participants were kept and safeguarded.
Justice. The researcher warrants that the participants were be treated equally, and
that there would be no biases, no favoritisms, and no qualifications on intellect, religion,
gender, economic status, and disabilities. It requires a reasonable allocation of the risks
and benefits as results of the research, and it is very important to acknowledge the
contributions of all the participants as they generally part of the success of the research.
28
Transparency. The researcher would make sure that the methods were clearly
discussed. Furthermore, any documents that are relevant in this study will be attached for
review of the readers. All and any other information‘s that are relevant in this study will
be provided for the consumption of the audience of this study.
Vulnerability of participants. The researcher ensures the safety of the
participants and is responsive to their needs, conditions, or priorities because they are
Senior Citizens who are considered vulnerable in this pandemic and are very susceptible
to the disease.
29
CHAPTER 3
RESULTS
Presented in this chapter are the analysis, interpretation and the findings of the
data gathered out of the research instruments used in the study to find out the Level of
Drug Compliance of the Senior Citizens of Kipalili San Isidro Davao del Norte.
30
Table 1.
The Demographic Profile of the Respondents in Terms of Age, Gender and
Frequency Percent
60-65 30 19.2
66-70 51 32.7
71-75 42 26.9
Valid 79-80 33 21.2
156 100.0
Total
Gender Frequency Percent

Female 89 57.1
Valid Male 67 42.9
Total 156
Educational level Frequency Percent
Primary 40 25.6
Secondary 95 60.9
Valid Tertiary 21 13.5
156 100.0
Total
Educational level.
Age. There were ranges of ages from 60-65 with a percentage of 19.2, 66-70 with a
percentage of 32.7, 71-75 with a percentage of 26.9 and 76-80 with a percentage of 21.2.
In this study, the age of the participants was obtained to determine if it can significantly
influence the level of drug compliance. Majority of the studies showed that age was
related to compliance, although a few researchers found age not to be a factor causing
31
non-compliance (Lorenc and Branthwaite 1993). From a review of the articles showing a
correlation between age and non-compliance, it would appear that the effect of age could
be divided into three major groups: the elderly group (over 55 years old), the middle-age
group (40 to 54 years old) and the young group (under 40 years old) (Murray et al 1986).
Several studies also attempted to venture plausible reasons for poorer compliance among
elderly patients (Stewart and Caranasos 1989). Elderly patients may have problems in
vision, hearing, and memory (Chizzola et al 1996). In addition, they may have more
difficulties in following therapy instructions due to cognitive impairment or other
physical difficulties, such as having problems in swallowing tablets, opening drug
containers, handling small tablets, distinguishing colors or identifying markings on drugs
(Chizzola et al 199). On the contrary, older people might also have more concern about
their health than younger patients, that‘s why older patients‘ non-compliance is non-
intentional in most cases. As a result, if they can get the necessary help from healthcare
providers or family members, they may be more likely to be compliant with therapies.
Gender. It is important to note that most of the respondents were Female
(57.1%) of the total compared to Male (42.9%) respondents. This demographic profiling
aims to determine which gender group affect the level of drug compliance. Research says
that it is more evident among men starting their twenties (Everrett B. & Zajacova A,
2015). In addition, Men have higher blood pressure than women through much of life
regardless of race and ethnicity (Ji H, & Sandberg K, 2012). The causes among men for
the development of this condition are stress, alcohol intake, and tobacco use (American
Heart Association, 2019).

32
Educational level. There were 40 individuals under elementary graduates with a
percentage of 25.6, 95 individuals under secondary graduates with a percentage of 60.9,
21 individuals under tertiary graduates with a percentage of 13.5. The table shows that
most of our respondents are secondary graduates with a percentage of 60.9. Several
studies found that patient with high knowledge and education might have higher
compliance (Yavuz et al., 2004). Intuitively, it may be expected that patients with higher
educational level should have better knowledge about the therapies and disease and
therefore be more compliance, however, researchers also found that even highly educated
patients may not understand their medication regimen (Dimatteo, 2000).
Factors Influencing Patient Compliance of the respondents.
Table 2.1
Cognitive and Psychomotor Development
Items AWM Description
Dili makalimot ug inom sa akong (mga) 3.160 Moderate
tambal.
Mabasa ug tarong ang mga 3.821 High
impormasyon nga nakabutang sa akong
(mga) tambal.
Maka kompara ug tambal sa uban pang 3.756 High
tambal.
Dili ko mag lisod ug tumar sa akong 3.327 Moderate
(mga) tambal.
Dili ko mag lisod ug pagkuha, pagkab- 3.231 Moderate
ot o pag abri sa tambal
OVERALL MEAN 3.459 High
33
Table 2.1 shows the Level of Factors Influencing Patient Compliance of Senior Citizen in
terms of Cognitive Development with an overall mean of 3.459, which is describes as
high. This indicates that the Level of Factors Influencing Patient Compliance of Senior
Citizen in terms of Cognitive and psychomotor development is always high. According to
some studies the possible reasons of poor compliance among older patients are that
elderly patients may have problems in vision, hearing, and memory. Thus, they have
more difficulties in following therapy instructions due to cognitive impairment,
disabilities and problems in swallowing tablets or capsules, opening drug containers, or
reading and identifying the drug product (Cooper et al., 2005).
Table 2.2
Patient’s Knowledge.
Kahibalo sa akong (mga) sakit 4.083 High
Kahibalo para sa asa ang (mga) 4.186 High

tambal nga gina-tumar.
Kahibalo kung kanus-a mo hunong 4.096 High
sa pag tumar sa tambal.
Kahibalo ko sa (mga) epekto sa 3.872 High
tambal na akong gina tumar
Kahibalo kung kanusa mo tumar sa 4.244 Very High
akong mga tambal.
terms of Patient‘s Knowledge with an overall mean of 4.096, which is described as high.
This indicates that the Level of Factors Influencing Patient Compliance of Senior Citizen
34
in terms of Patient‘s Knowledge is always high. Several studies found that patient with
high knowledge and education might have higher compliance (Yavuz et al., 2004).
Intuitively, it may be expected that patients with higher educational level should have
better knowledge about the therapies and disease and therefore be more compliance,
however, researchers also found that even highly educated patients may not understand
their medication regimen (Dimatteo, 2000). Other researchers showed that the patients
with lower education level have better compliance according to Senior et al (2004).
Table 2.3
Patient – Healthcare Professional Relationship
Naga follow-up checkup 2.859 Moderate

paghuman ug tumar sa akong
(mga) tambal tanan nga
nakabutang sa reseta.
Naga salig sa akong doctor, 4.340 Very High
parmasista ug uban pang
propesyonal sa healthcare.
Naga paminaw ug tarong sa 4.288 Very High
gihatag nga konsulta bahin sa
akong (mga) sakit ug (mga)
tambal.
Pag makabati ug sakit sa lawas o 2.744 Moderate
uban pa sa doctor o parmasista
dayon ko magpa konsulta.
Mas mabati nakong mugaan 4.295 Very High
akong paminaw pag muinom sa
tambal nga gihatag sa doctor o
parmasista
35
terms of Patient – Healthcare Relationship with an overall mean of 3.705, which is
described as high. This indicates that the Level of Factors Influencing Patient
Compliance of Senior Citizen in terms of Patient – Healthcare Relationship is always
high. Studies found that compliance is good when prescribers are emotionally supportive,
giving reassurance or respect, and treating patients as an equal partner (Lawson et al.,
2005). According to research by Mainous et al (2016), patient medication compliance is
positively linked to the patient-prescriber relationship, and their findings suggest that
efforts to establish a relationship between the physician and the patient can improve
primary care outcomes and ensure that the patient understands the physician, patient's
issue, and the physician's recommendations. Worley and Hermansen-Kobulnicky (2003)
have discovered a connection between the patient–pharmacist relationship and diabetes
patients' ability to administer their own medications and may enhance the medication
self-efficacy. In addition, clinical pharmacists help the patients in better managing their
medications and reducing anxiety associated with taking multiple medications and the
trust is regarded as a broad concept that represents patients' overall trust in clinical
pharmacists (AK Mohiuddin, 2019).

36
Level of drug compliance of the Senior Citizens in Kipalili, San Isidro, Davao del
Norte.
Table 3
The Level of Drug Compliance of Senior Citizens in Kipalili San Isidro Davao del
Norte
Naga-tumar ug tambal sa sakto nga oras. 4.109 High
Naga-tumar ug tambal adlaw-adlaw. 3.769 High
Ginadala permi ang tambal kung mo lakaw 4.038 High

or mo biyahe.
Naga sunod ug tarong sa direksyon bahin 4.032 High
sa pagtumar ug tambal.
Naga hunong sa pagtumar ug tambal kung 3.487 High
na humana ang gi-rekomenda na adlaw sa
doctor or parmasista
Table 3 represented the Level of drug compliance of the Senior Citizens in Kipalili San
Isidro Davao del Norte with an overall mean of 3.888, which described as high. This
indicates that the Level of Drug Compliance of the Senior Citizens in Kipalili San Isidro
Davao del Norte is always high. According to the study of Nikolaus (2018) elderly
patients were found to be more likely to adhere to a medication. Medication compliance
in elderly patient is very complex behavior that often involves the completion of variety
of frequently difficult tasks for extended time periods. while the elderly do not exhibit
37
noncompliance behavior more often than the younger age group, this behavior may be of
greater significance in the older patient (Morrow et.al, 2015).
Significant difference in the level of drug compliance according to demographics.
Table 4.1
One-Way ANOVA Test for Age and Drug Compliance
N Mean Std. Deviation Sig.
60-65 30 3.8330 .81328
66-70 51 3.8753 .89025
71-75 42 4.0072 .82490 .632
76-80 33 3.7638 .75538
Total 156 3.8791 .82759
Table 4.1 One-Way ANOVA Test showed that there was no significant difference
in drug compliance between the age of senior citizen with a p-value of 0.632 which are
greater than to 0.005, with mean rank of drug compliance score of 4.0072 in ages 71-75,
3.8753 for ages 66-70, 3.8330 for ages 60-65 and 3.7638 for ages 76-80. According to
Park et al (2016)'s report on drug compliance in patients, older patients have higher levels
38
of drug compliance than younger patients who are busy and have irregular schedules,
making it difficult to remember to take their medicines. Thus, it is not age itself has a
negative impact on drug compliance, but rather other variables that include patient‘s
motivation and
understanding as well as their cognitive and memory status. Older adults who have mild
to moderate cognitive impairment may have significant insight to the potential
implications of not taking their medication. Most of the studies showed that age was
related to compliance, however a few researchers found causing non-compliance (Wild et
al, 2016). Poor drug compliance also occurs in adolescents and children with disease
because young children need more help from their parents to implement treatment.
Therefore, their poorer drug compliance may be due to lack understanding because of
their age that could therefore influence their drug compliance (Wild et al,2016)
Table 4.2 and 4.3
Group Statistics
Gende N Mean Std. Std. Error T Df Sig
r Deviation Mean (2-
tailed)
Drug Female 89 3.8675 .86112 .09128 -.201 154 .841

Compliance Male 67 3.8945 .78698 .09615
Independent Samples T-Test for Gender and Drug Compliance

39
From the result, we can conclude that there was no significant difference between
the drug compliance and the gender of the respondents with a p-value of 0.841 which are
greater than to 0.005. Despite of male having a higher mean of 3.8945 compared to
female with mean of 3.8675. A recent study shows that life course gender-role traits and
social stereotypes were also reported to affect medication adherence. While gender-based
differences regarding perceived barriers to medication adherence were not suggested to
exist, important differences in the distribution of medicines, metabolism, efficacy, and
side effects of prescribed medicines have been reported for both sexes, with a potential
effect on medication adherence (Mahmoodi H 2019). According to Ahmed et al. (2016),
males and females have different healthcare attitudes and behaviors. It appears that when
it comes to treatment adherence, there may be more pertinent and influential factors at
play than gender.
Table 4.4
One-Way ANOVA for Educational Level and Drug Compliance
ANOVA
Drug Compliance
N Mean Std. Deviation Std. Error F Sig.
40 3.7560 .73113 .11560

Elementary
.640 .529
95 3.9103 .90016 .09235
Secondary
21 3.9725 .64277 .14026

Tertiary
Total 156 3.8791 .82759 .06626

40
A One-Way ANOVA Test showed that there was no significant difference in drug
compliance between the educational level of senior citizen with a p-value of 0.529 which
are greater than to 0.005. Tertiary level had the highest mean value of 3.9725, followed
by secondary level with mean value of 3.9103, and elementary level with mean value of
3.7560 and had an overall mean of 3.8791. Several studies found that patients with
higher educational level might have higher compliance and understanding of the drugs
source (Apter et al 1998) while some studies found no association (Norman et al 1985).
Intuitively, it may be expected that patients with higher educational level should have
better knowledge about the disease and therapy and therefore be more compliant.
However, DiMatteo found that even highly educated patients may not understand their
conditions or believe in the benefits of being compliant to their medication regimen
(DiMatteo 1995). Other researchers showed that patients with lower education level have
better compliance (Kyngas and Lahdenpera 1999; Senior et al 2004). Patients with lower
educational level might have more trust in physicians‘ advice. From these results, it
seems that educational level may not be a good predictor of therapeutic compliance.
41
CHAPTER IV
SUMMARY, CONCLUSION, AND RECOMMENDATION
This chapter summarizes findings, conclusions, and recommendations drawn by the
researchers from the results obtained.
Summary of Findings
The purpose of this study is to determine and evaluate the Level of Drug
Compliance in the Senior Citizens. Specifically, the researchers aim to answer the
following research questions.

42
The null hypothesis stated the following and was tested on a level of significance of
0.05: H0: There is no significant relationship in terms of age and educational level to the
Level of Drug Compliance of the Senior Citizens in Kipalili San Isidro Davao del Norte.
Thus, it has significant relationship in terms of gender to the Level of Drug Compliance
of the Senior Citizens in Kipalili San Isidro Davao del Norte.
The research was a descriptive study with a quantitative research design. The
Senior Citizens of Kipalili, San Isidro, Davao del Norte were the participants of this
study. The researchers considered that the participants were equally suitable of this study
since majority of them were more prone to difficulties of drug compliance and the
researchers ensures the participant‘s safety since they belong to as vulnerable
participants.
In gathering the data, a Bisaya translated survey questionnaire was used to gather
the Senior Citizens‘ data through tapping a barangay official in Kipalili, San Isidro,
Davao del Norte. The used parameter is a 5-point Likert Scale which is also translated to
Bisaya language for the participants preferences. It is arranged in descending order in
which 5 is strongly agree (Uyon kaayo), 4 for sometimes agree (Usahay uyon), 3 for
agree (Uyon), 2 for disagree (Dili uyon) and 1 for strongly disagree (Dili gyud uyon). A
total of 156 participants were included in the study. Thirty individuals belong to ages 60-
65 years old, 51 individuals for ages 66-70 years old, 42 individuals for ages 71-75 years
old and 33 individuals for ages 76-80 years old.

43
The level of factors influenced the patient‘s compliance of respondents in terms of
cognitive development with an overall mean of 3.459 which described as high and
indicates that the level of factors influencing the patient compliance of respondents in
terms of cognitive development is always high. For the patient’s knowledge, it has an
overall mean of 4.096 which described as high and indicated that the level of factors
influencing the patient compliance of respondents in terms of patient’s knowledge is
always high. For the patient-healthcare relationship, it has an overall mean of 3.705
which described as high and indicated that level of factors influencing the patient
compliance of respondents in terms of patient-healthcare relationship was always high.
Thus, the overall mean of all the factors influenced the patient compliance is 3.753 which
described as high. This indicates that the level of factors influencing patient compliance
is always high.
The level of drug compliance of the senior citizens in Kipalili, San Isidro, Davao
del Norte has an overall mean of 3.888, which described as high. This indicates that the
Level of Drug Compliance of the Senior Citizens in Kipalili San Isidro Davao del Norte
is always high.
The study shows that there was no significant difference of the demographic
profiles of respondents to their drug compliance. Independent Samples T-Test shows the
gender‘s p-value of 0.841 which is greater than to 0.005 level of significance, although
male group attained the highest drug compliance level of 3.8945 than to female group of
3.8675. One-Way ANOVA shows the result age with p-value of 0.632 and 0.529 for
44
educational level, which are both greater than to 0.005 level of significance. The mean
rank of drug compliance score of ages 71-75 years old is 4.0072, for ages 66-70 years old
is 3.8753, ages 60-65 years old is 3.8330 and ages 76-80 years old is 3.7638. Thus, the
same test is used in educational level which it shows that there was no significant
difference in drug compliance between the educational level of Senior Citizens with a p-
value of 0.529, with mean rank of drug compliance score of 3.9725 for tertiary level,
3.9103 for secondary level and 3.7560 for elementary level.
Conclusion
The following conclusions were drawn based on prior results and observations:
1. Result showed that majority of the respondents are from ages of 66-70 years old (32.7%)
which are mostly female (57.1%), and mostly from secondary level of education (60.9%).
2. It was found that the three patient compliance factors such as cognitive development,
patient's knowledge, and patient healthcare relationship are of high level to influence the
compliance of the senior citizens in their medication regimen. The cognitive
development may negatively affect of how the senior citizens would comply to their
medication regimen especially those having high cognitive development which is
common in senior citizens. Aside from that, those senior citizens with better knowledge
on their medication, how to take their medication, what exact time they would take it and
45
most importantly, their knowledge on how important does following an instruction and
what was being prescribed by their physician. With high patient's knowledge, it would
result to high compliance as well. In addition, the relationship of the patient and the
physician or pharmacist or to other healthcare professional are more evident to influence
the patient's drug compliance. In a way that it creates an effective connection and
communication between the senior citizens and to the healthcare professional in assessing
their condition, managing their health, laboratory tests, in selecting appropriate
medication and maximize the therapeutic effect of the medication and promote life
assurance. It is an evident to conclude that these factors are highly influenced the senior
citizens on their drug compliance.
3. In general, the majority of Senior Citizens in Kipalili San Isidro Davao del Norte comply
to their medication regimen and have the ability and willingness to follow a prescribed
therapeutic regimen. This could be because they are more concerned with the medication
that they take on a daily basis and being able to relieve their pain or illnesses.
4. Since the null hypothesis was rejected. This shows that there was no significant
difference in the level of drug compliance of the senior citizens in terms of their
demographic profile. This could be mean that no matter what range of age does a senior
citizen belong, what kind of gender they are, and what level their education is, they are
still not correlated to how the senior citizens would comply to their medication regimen.
46
Recommendation
Based on the aforementioned findings and conclusions of this study, the following
recommendations are offered:
1. The drug compliance varies greatly by gender, especially among male senior citizens in
the barangay of Kipalili, with the results which are significantly lower than those of
female senior citizens. The health authorities must conduct programs on implementing
drug compliance to enhance and improve their compliance on medication.
2. Propose the study‘s finding to the Municipality of San Isidro, Davao del Norte health
office for the purpose of developing and enhancing the drug compliance among senior
citizen in the Barangay Kipalili.
3. Health practitioners such as pharmacists must encourage in dissemination of knowledge
about drug compliance and its advantages and risks especially to the residents of
Barangay Kipalili, San Isidro, Davao del Norte and other rural areas.
4. Promote Barangay Kipalili to the community pharmacy to bring attention and have more
stable pharmacy.
5. Suggest to other future researchers to include polypharmacy of elderly in their study.
6. Conduct further research regarding the patient compliance and drug compliance of senior
citizen of the Baranggay Kipalili, San Isidro, Davao del Norte to learn about other factors
that may affect drug compliance that were not considered in our study.
47
7. Use this study as a reference for extending the pharmacy department‘s reach into the
community, especially in rural areas.
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53
APPENDICES
54
Appendix A
LETTER TO CONDUCT THE STUDY

March 04, 2021
Rosa Vienna J. Ilog, RPh, MSPharm
Dean of Pharmacy
Tagum Doctors College Inc.
Greetings!
We, third year students of Tagum Doctors College Inc. under the department of
Bachelor of Science in Pharmacy will conduct survey via printed questionnaires through
the help of Barangay Health Worker (BHW) and Barangay Officials and will be
disseminated to the participants as a part of our research entitle: ―THE LEVEL OF
DRUG COMPLIANCE OF SENIOR CITIZENs OF BARANGAY KIPALILI SAN
ISIDRO DAVAO DEL NORTE‖
In line with this, may we respectfully request your good office to allow us to
conduct surveys to the chosen Senior Citizens for the said research.
We are looking forward for your utmost consideration and approval.
Thank you so much and more power.
Respectfully yours,
55
Appendix A (Continued)
Arendain, Jhen Mei

Lamsin, Leneah Jeanneth
Suello, Xynthea Lei
Noted by: Approved by:
Nevia Sheena B. Maranan. RPh Rosa Vienna J. Ilog RPh,

MSPharm
Research Adviser Dean of Pharmacy
56
Appendix B
PROOFREADING CERTIFICATION

Rabe Subd., Visayan Village, Tagum City
CERTIFICATE OF PROOFREADING
This is to certify that the undergraduate thesis ―THE LEVEL OF

DRUG COMPLIANCE OF THE SENIOR CITIZENS OF KIPALILI,
SAN ISIDRO, DAVAO DEL NORTE”, was examined and proofread by
the undersigned person. That she is academically and professionally rightful
to examine both the substance and the surface of this paper
RICA MAE R. LARGO, LPT
Proofreader
57
Appendix C
STATISTICIAN’S CERTIFICATION

STATISTICIAN‘S CERTIFICATION
This is to certify that the undergraduate thesis ―THE LEVEL OF

DRUG COMPLIANCE OF THE SENIOR CITIZENS OF KIPALILI,
SAN ISIDRO, DAVAO DEL NORTE”, has been statistically reviewed by
the undersigned. Attached on the next pages is the summary of the results
BOBBY B. MAGNO
Statistician
58
Appendix D
INFORMED CONSENT

Medical Laboratory Science Department
RESEARCH INFORMED CONSENT
Date:
Research Title: The Level of Drug Compliance of the Senior Citizens of Kipalili San
Isidro Davao del Norte
The following information provided is to help you decide whether you wish to
participate in the present study. You should know and be aware of your rights to decide
whether not to participate or take it back any time without hesitation and/or affecting
your relationship with us, the researchers.
The purpose of this study is to further determine and understand the level of drug
compliance of the Senior Citizens in Barangay Kipalili San Isidro Davao del Norte. This
will serve as the basis for further studies of future researchers.
The data will be collected using a brief survey through the help of Barangay
officials and Barangay Health Workers (BHW) in Barangay Kipalili San Isidro and this
will be disseminated by the researchers to the participants via printed questionnaire, then
ask quite several questions on how they deal their drug compliance and how they manage
to follow their drug prescription.
Before participating, if you still have queries regarding with the study then, do not
hesitate to ask. After completing our study, we are grateful to share the results with you
as you had been part on this stiudy. Don‘t be worried as your name will not be included
in the result of this study and your identity will only be identified by the researchers. The
participants are adequately protected and not disclosed to any unauthorized persons, and
will ensure the full confidentiality of your responses given.
We are looking forward for your positive response. Please sign this consent form.
You are signing it with full knowledge of the nature and purpose of the procedure. A
copy of this form will be given to you for keeps.
59
Sincerely yours,
Appendix D (continued)
Arendain, Jhen Mei

Lamsin, Leneah Jeanneth
Suello, Xynthea Lei
Nevia Sheena Maranan, RPh, MSPharm___

Name of the Respondent Research Adviser
60
Appendix E
VALIDATION FORM
61
Appendix F
QUESTIONNAIRE
Pangalan: (Optional) Edad: Petsa:

Educational Level:
 Elementary Graduate  High School Graduate  College Graduate
Gender:
 Female  Male
THE LEVEL OF DRUG COMPLIANCE AMONG SENIOR CITIZEN OF THE

BARRANGAY KIPALILI SAN ISIDRO DAVAO DEL NORTE
Direksyon: Palihog sa pagtubag aning mga pangutana mahitungod sa nasinati nimo sa

imong tambal. Hinumdomi na walay tama og mali nga tubag niini. Palihog tsekan ( )
ang napili nga tubag sa kada pangutana.
Mao kini ang mga interpreatsyon sa kada puntos.
Puntos Deskripsiyon Interpretasyon
Uyon kayo Kini nga pahayag hingpit

5 nga tinoud
Usahay uyon Kini nga pahayag usahay
4 tinoud para sa ako
Uyon Tinoud kini nga pahayag
3 kanako
Dili uyon Kini nga pahayag kanunay
2 dili tinoud sa ako
Dili gyud uyon Kini nga pahayag dili gyud
1 tinoud
62
Cognitive and psychomotor development 5 4 3 2 1
Ako kay…
1.Dili Makalimot ug inom sa akong (mga) tambal.
2. Mabasa ug tarong ang mga impormasyon nga nakabutang

sa akong (mga) tambal.
3. Maka kompara ug tambal sa uban pang tambal.
4. Dili mag lisod ug tumar sa akong (mga) tambal.
5. Dili maglisod ug pagkuha, pagkab-ot o pag abri sa tambal.
Appendix F (continued)
Kahibalo sa pasyente (Patient’s Knowledge) 5 4 3 2 1

Ako kay…
1.Kahibalo sa akong (mga) sakit.
2. Kahibalo para asa ni akong mga tambal nga gina-tumar.
3. Kahibalo kung kanus-a mo hunong sa pag-tumar sa tambal.
4.Kahibalo ko sa (mga) epekto sa tambal na akong gina-tumar.
5. Kahibalo kung kanus-a mo tumar sa akong mga tambal.

63
Appendix F (continued)
Patient-Healthcare Professional Relationship 5 4 3 2 1

Ako kay…
1. Naga follow-up checkup paghuman ug tumar sa akong (mga)
tambal tanan nga nakabutang sa reseta.
2.Naga-salig sa akong doktor, parmasista ug uban pang propesyonal `
sa healthcare.
3. Naga paminaw ug tarong sa gihatag nga konsulta bahin sa akong
(mga) sakit ug (mga) tambal.
4. Pag makabati ug sakit sa lawas o uban pa sa doctor o parmasista
dayon ko magpa-konsulta.
5. Mas mabati Nakong mugaan akong paminaw pag muinom sa
tambal nga gihatag sa doctor o parmasista
Drug Compliance 5 4 3 2 1
Ako kay…
1. Naga-tumar ug tambal sa sakto nga oras.
2. Naga-tumar ug tambal adlaw-adlaw.
3. Ginadala permi ang tambal kung mo lakaw or mo biyahe.
4. Naga sunod ug tarong sa direksyon bahin sa pagtumar ug

tambal.
5. Naga hunong sa pagtumar ug tambal kung nahugpaw o
nawala na ang sakit nga gibati biskan wala pa nahuman ang gi-
rekomenda na adlaw sa doktor.
64
Appendix G
THE DEMOGRAPHIC PROFILE OF THE RESPONDENTS IN TERMS OF
AGE, GENDER, AND EDUCATIONAL LEVEL
Frequency Percent
Age
60-65 30 19.2
66-70 51 32.7
71-75 42 26.9
Valid
79-80 33 21.2
Total 156 100.0
Gender Frequency Percent

Female 89 57.1
Valid Male 67 42.9
Total 156
Educational level Frequency Percent
Primary 40 25.6
Secondary 95 60.9
Valid Tertiary 21 13.5
Total 156 100.0
65
Appendix H
THE LEVEL OF FACTORS INFLUENCING THE PATIENT COMPLIANCE OF

SENIOR CITIZENS IN KIPALILI SAN ISIDRO DAVAO DEL NORTE
Factors AWM Description
Cognitive and psychomotor 3.459 Moderate

Development
Patient‘s Knowledge 4.096 High
Patient – Healthcare 3.705 High

Relationship
Overall Mean 3.753 High

66
Appendix I
THE LEVEL OF DRUG COMPLIANCE OF SENIOR CITIZENS IN KIPALILI

SAN ISIDRO DAVAO DEL NORTE
1. Naga-tumar ug tambal sa sakto 4.109 High

nga oras.
2. Naga-tumar ug tambal adlaw- 3.769 High
adlaw.
3. Ginadala permi ang tambal kung 4.038 High
mo lakaw or mo biyahe.
4. Naga sunod ug tarong sa 4.032 High
direksyon bahin sa pagtumar ug
tambal.
5. Naga hunong sa pagtumar ug 3.487 High
tambal kung na humana ang gi-
rekomenda na adlaw sa doctor or
parmasista
67
Appendix J
INDEPENDENT SAMPLE T- TEST FOR DRUG COMPLIANCE AND GENDER
Group Statistics
Gender N Mean Std. Std. Error Mean

Deviation
Drug Female 89 3.8675 .86112 .09128
Compliance Male 67 3.8945 .78698 .09615
Independent Samples Test

68
Levene's Test t-test for Equality of Means

for Equality of
Variances
F Sig. t df Sig. (2- Mean
tailed) Difference
Equal .018 .895 -.201 154 .841 -.02700

variances
assumed
Drug Compliance Equal -.204 148.2 .839 -.02700
variances 59
not
assumed
Appendix K
TABLES FOR ONE –WAY ANOVA OF DRUG COMPLIANCE AND AGE
ANOVA
Drug Compliance
Sum of df Mean Square F Sig.
Squares
Between 1.192 3 .397 .576 .632
Groups
Within Groups 104.967 152 .691
Total 106.159 155
69
Descriptives
Drug Compliance
N Mean Std. Deviation Std. Error
60-65 30 3.8330 .81328 .14848

66-70 51 3.8753 .89025 .12466
71-75 42 4.0072 .82490 .12728
76-80 33 3.7638 .75538 .13150
Total 156 3.8791 .82759 .06626
70
Appendix L
TABLES FOR ONE – WAY ANOVA OF DRUG COMPLIANCE AND AGE
ANOVA
Drug Compliance
Sum of Df Mean F Sig.
Squares Square
Between Groups .881 2 .441 .640 .529
Within Groups 105.278 153 .688
Total 106.159 155
Descriptives
Drug Compliance
N Mean Std. Deviation Std. Error
Elementary 40 3.7560 .73113 .11560

Secondary 95 3.9103 .90016 .09235
Tertiary 21 3.9725 .64277 .14026
Total 156 3.8791 .82759 .06626
71
Appendix M
Mean Range Description Interpretation

4.20 – 5.00 Very High The level of factors influencing patient
compliance of senior citizens in terms of
cognitive development is always
outstanding.
3.40 - 4.19 High The level of factors influencing patient
cognitive development is always high.
2.60 – 3.39 Moderate The level of factors influencing patient
cognitive development is always fair.
1.80 – 2.59 Low The level of factors influencing patient
cognitive development is always low.
1.00 - 1.79 Very Low The level of factors influencing patient
cognitive development is always very
low.
72
CURRICULUM VITAE
JHEN MEI LUCERO ARENDAIN
Bl. 04, Lot 18, Apitong St., Bermudez
Subdv., Apokon Tagum City Davao del Norte
Cell Number: 09058358736
e-mail address: bsph3.jmarendain@gmail.com
PERSONAL INFORMATION
Age: 20 years old
Date of Birth: October 29, 2000
Birthplace: Prk. 8 Andap, Laak, Davao de Oro
Nationality: Filipino
Religion: Roman Catholic
Civil Status: Single
EDUCATIONAL BACKGROUND
Primary: Andap Elementary School (2006-2012)
Secondary: Melale National High School (2012-2016)
Senior High School: University of Mindanao Tagum City (2016-2018)

73
CURRICULUM VITAE
LENEAH JEANNETH MISA LAMSIN
Prk. 2 Kipalili San Isidro Davao del Norte
e-mail address: bsph3.ljlamsin@gmail.com
Age: 21 years old
Date of Birth: September 18, 1999
Birthplace: Bishop Joseph Regan Memorial Hospital, Christ the King Road,
Tagum, Davao del Norte
Primary: Magugpo Pilot Central Elementary School (2006-2009)
Kipalili Elementary School (2009-2012)
Secondary: Maryknoll High School of Asuncion Inc. (2012-2016)

74
CURRICULUM VITAE
XYNTHEA LEI DUAZO SUELLO
Lynville Subdivision, Mankilam, Tagum City
Davao del Norte
e-mail address: bsph3.xlsuello@gmail.com
Age: 21 years old
Date of Birth: June 16, 1999
Birthplace: Bishop Joseph Regan Memorial Hospital, Tagum City
Primary: Magugpo Pilot Central Elementary School (2006-2012)
Secondary: Tagum City National Comprehensive High School
(2012-2016)

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i

THE LEVEL OF DRUG COMPLIANCE OF THE SENIOR CITIZEN

ARENDAIN, JHEN MEI L.

This thesis entitled “THE LEVEL OF DRUG COMPLIANCE OF THE SENIOR

CITIZENS OF KIPALILI, SAND ISIDRO, DAVAO DEL NORTE” prepared by

JHEN MEI L. ARENDAIN, LENEAH JEANNETH M. LAMSIN and XYNTHEA

LEI D. SUELLO in partial fulfillment of the requirements for the degree of

Bachelor of Science in Pharmacy has been examined, approved and endorsed.

NEVIA SHEENA B. MARANAN, RPh, MSPharm

APPROVED by the Research Committee on the Oral Examination with a grade

ROSA VIENNA J. ILOG, RPh, MSPharm

MA. LEILANI A. BETONIO, RPh, MSPharm JESA S. MADELO,RPh, PhD

ACCEPTED and APPROVED in partial fulfillment of the requirements for the

degree of Bachelor of Science in Pharmacy.

ROSA VIENNA J. ILOG, RPh, MSPharm

To our research adviser, Nevia Sheena B. Maranan, RPh, MsPharm,

who has been a constant source of encouragement and support for us

throughout our research.

Department of Pharmacy, who worked tirelessly to ensure that the researchers

did their best and that we could conduct this study.

To the members of the panel, Mrs. Leilani Betonio, RPh, MsPharm,

and constructive criticism to help us improve our research.

To the Barangay official and health workers of Kipalili, San Isidro,

Mrs. Arlene C. Velarde, and Emelita D. Arangis for assisting us in gathering

our data and for their unwavering support.

To Mr. Bong Magno, our statistician, for expanding his knowledge of

data interpretation and analysis in our research.,

To Ms. Rica M. Largo, our grammarian, for sharing her expertise by

checking and reviewing our research.

To our families, who have contributed time, love, moral knowledge,

and financial support to this research.

characteristics of respondents. Participants were one hundred fifty-six (156) Senior

cognitive development, patient‘s knowledge, and patient-healthcare professional

had no significant difference on the drug compliance of the respondents.

Keywords: Drug Compliance, Senior Citizens, Cognitive Development, Patient’s

Knowledge and Patient-Healthcare Professional Relationship

LIST OF TABLES vii

LIST OF FIGURES viii

Chapter I PROBLEM AND ITS SETTING

Background of the Study 1

Statement of the Problem 4

Significance of the Study 5

Scope and Limitation 9

Review of Related Literature 10

Place of the Study 21

Sample and Sampling Technique 23

CHAPTER III: RESULTS AND DISCUSSION

CHAPTER IV: SUMMARY, CONCLUSION, AND RECOMMENDATION

A. Letter to Conduct the Study

1. Demographic Profile of the Respondents 30

2. Level of Factors Influencing Drug Compliance in Cognitive 32

And Psychomotor Development

3. Level of Factors Influencing Drug Compliance in Patient‘s 33

4. Level of Factors Influencing Drug Compliance in Patient - 34

Healthcare Professional Relationship

5. Level of Drug Compliance of Senior Citizen in Kipalili 36

San Isidro, Davao del Norte.