The use of multiple prescription drugs, known as polypharmacy, is increasingly common among older adults. According to the US Centers for Disease Control and Prevention, over 83% of adults aged 60-79 take one or more prescription medications, with 34.5% taking five or more. This prevalence presents unique challenges in medication management and highlights the need for effective strategies to ensure safe and effective drug use.
Elderly woman organizing her medications.
Polypharmacy can lead to potential complications, including drug interactions, adverse drug events, and difficulty adhering to complex medication regimens. These factors can contribute to avoidable healthcare utilization and diminished quality of life. Managing multiple medications can be especially challenging for older adults living at home, often leading to the development of personalized, yet sometimes risky, medication management routines.
Understanding Home Medication Management
A qualitative study published in Pharmacy explored how community-dwelling older adults (55+ years) prescribed four or more medications manage their medications at home. The study revealed that two primary wellbeing goals drove home medication management: maintaining control and avoiding vulnerability. This research emphasizes the importance of understanding individual patient perspectives and tailoring medication management strategies accordingly.
The study, conducted as part of a larger intervention study at a community pharmacy, employed a medication management questionnaire and in-home interviews with participants. Researchers observed participants’ medication management practices in their homes and utilized the Systems Approach to Home Medication Management (SAHMM) model to analyze factors influencing adherence.
Table illustrating the Systems Approach to Home Medication Management (SAHMM) model.
The SAHMM model considers three key components:
- Person: Individual factors such as cognitive abilities, health literacy, and personal preferences.
- Tools and Technology: Resources used for medication management, including pill boxes, medication lists, and reminder apps.
- Household: The home environment and support systems available to the individual.
Common Medication Management Practices
The study identified several common medication management activities:
- Procurement: Obtaining medications from pharmacies.
- Organization: Strategies for storing and organizing medications, with 7-day pill boxes being the most prevalent method.
- Medication Lists: Maintaining lists of current medications.
- Routine: Establishing a regular routine for medication intake.
- Monitoring: Tracking medication use and potential side effects.
While pill boxes and medication lists were frequently used, the research suggested a need for improvements in these tools to enhance their effectiveness.
Personalized Approaches to Medication Adherence
The findings underscore that achieving medication adherence goes beyond simply aiming for clinical outcomes. Collaboration between healthcare providers and patients, focusing on individual patient goals and preferences, is crucial. When assessing adherence, healthcare professionals should consider patients’ motivations, daily routines, and the tools they utilize. Understanding these individual factors can lead to more effective interventions and improved adherence.
Optimizing Medication Management for Older Adults
Although many older adults develop their own systems for managing medications, some practices may pose risks. Pharmacists play a critical role in patient education and counseling. During medication dispensing or hospital discharge, pharmacists should provide personalized guidance on safe and effective home medication management techniques. By tailoring strategies to individual routines and preferences, healthcare providers can empower older adults to manage their medications safely and effectively.
Conclusion: Enhancing Medication Management and Quality of Life
Improving medication adherence in older adults requires a patient-centered approach that considers individual needs and preferences. By understanding the challenges of polypharmacy and implementing personalized strategies, healthcare professionals can empower older adults to take control of their medication regimens, leading to improved health outcomes and enhanced quality of life. For personalized treatment plans, consult with a healthcare professional today.
References
- Hales CM, Servais J, Martin CB, Kohen D. Prescription Drug Use Among Adults Aged 40–79 in the United States and Canada. NCHS Data Brief. 2019 Aug;(347):1-8.
- Fadare O, Witry M. “There Is Method to This Madness” A Qualitative Investigation of Home Medication Management by Older Adults. Pharmacy (Basel). 2023;11(2):42. Published 2023 Feb 23. doi:10.3390/pharmacy11020042
- Doucette WR, Vinel S, Pennathur P. Initial development of the Systems Approach to Home Medication Management (SAHMM) model. Res Social Adm Pharm. 2017 Jan-Feb;13(1):39-47. Published 2016 Jan 7. doi:10.1016/j.sapharm.2015.12.013.
