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GERIATRICS

Assessment of Older Adults' Knowledge of and Preferences for Medication Management Tools and Support Systems

Acting Assistant Professor, Department of Pharmacy, University of Washington, Seattle

Shelly L Gray, PharmD MS

Professor, Department of Pharmacy, University of Washington

Soo Borson, MD

Professor, Department of Psychiatry and Behavioral Sciences, University of Washington

Reprints: Dr. Lakey, School of Pharmacy, University of Washington, Box 357630, Seattle, WA 98195, fax 206/543-3835, slakey{at}u.washington.edu

BACKGROUND: A variety of strategies are available to assist older adults who have difficulties managing medications. Little is known about older adults' knowledge of or willingness to use these strategies.

OBJECTIVE: To assess older adults' current use of, knowledge of, and preferences for medication management tools and supports.

METHODS: A cross-sectional study was conducted at a continuing care retirement community. All 152 independent-living residents were approached for participation. We developed a 6-page survey to gather information about knowledge of and preferences for medication management tools (eg, medi-sets, bubblepacks) and supports (eg, family, caregivers, regimen simplification). Information on demographic variables, medication management capacity, cognition, self-reported difficulty taking medications, and medication use were collected along with survey answers during an in-home interview. ² and t-tests were used to compare knowledge and preferences by complexity and organizer use.

RESULTS: Our sample consisted of 109 participants ranging in age from 73 to 98 years (average 85.9). Most of the subjects were well educated (average 15.5 y of education), 98% were white, and 80% were female. The majority (82%) were using a medication tool, mainly simple, self-filled medi-sets (62%) and easy-open vials (55%). Knowledge about, use of, and preferences for other devices, including pharmacist-filled tools and programmable devices, were low. Participants who used medication organizers rated self-filled medi-sets higher than did non-users (4.7 vs 1.6; p < 0.01). Only 18% of participants had asked a provider to simplify their medications, while 40% did not realize that they could do so. Of those who did ask a provider, 80% asked a physician.

CONCLUSIONS: Educational strategies are needed to increase awareness of the pharmacist's role in facilitating medication management and the option of simplifying complex regimens. It is within the scope of pharmacy to provide this type of medication education.

Key Words: adherence, medication management, medication supports

Published Online, May 26, 2009. www.theannals.com, DOI 10.1345/aph.1L704