Improving Medication Management Among At-Risk Older Adults

Abstract

Low health literacy is common among Medicare recipients and affects their understanding of complex medication regimens. Interventions are needed to improve medication use among older adults, while addressing low health literacy. Community-dwelling older adults in this study were enrolled in an inner-city adult day center. They completed a baseline measure of health literacy, medication self-efficacy, and medication adherence. They were provided with a personalized, illustrated daily medication schedule (PictureRx™). Six weeks later, their medication self-efficacy and adherence were assessed. Among the 20 participants in this pilot project, 70% had high likelihood of limited health literacy and took an average of 13.2 prescription medications. Both self-efficacy and medication adherence increased significantly after provision of the PictureRx cards (p<0.001 and p<0.05, respectively). Al participants rated the PictureRx cards as very helpful in terms of helping them remember the medication's purpose and dosing. Illustrated daily medication schedules improve medication self-efficacy and adherence among at-risk, communitydwelling older adults. BackgroundHealth literary is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions (Institute of Medicine [IOM], 2004). Low health literacy adversely affects health and health care utilization, and it contributes to health disparities (IOM, 2004). Limited health literacy is associated with a substantial increase in mortality among communitydwelling elders (Sudore et al., 2006), and is a factor in predicting all-cause mortality and cardiovascular death in older adults (Baker et al., 2007).Low health literacy is prevalent among Medicare enrollees (Gazmararian et. al, 1999) who experience a large burden of chronic illness (

The effect of visual interventions on illness beliefs and medication adherence for chronic conditions: A scoping review of the literature and mapping to behaviour change techniques (BCTs)

“…Two were delivered via a smartphone app 79,80 , 1 was accessed via a digital tablet 81 whilst the remainder were paperbased medication schedules. Six of the 12 studies reported statistically significant adherence outcomes [79][80][81][82][83][84] . Of the 2 studies reporting illness belief outcomes, 1 was effective 80 .…”

A rapid review of interventions to improve medicine self‐management for older people living at home

“…In five studies, 47,50,51,68,69 education followed assessment of anticholinergic risk, 47 safe management of medicines, 50 ability to manage medicines, 51 diabetes self‐care abilities 69 and comprehensive assessment 68 . Education was delivered both one to one 39–41,45,48–53,55,59,60,64,66,68,70,71 and in groups 42,54,56,60,67 . Techniques and tools included coaching, 41,48,49,66 role play, 54 teach‐back/show‐back, 53,60,66 group discussion, 58,60 dilemma scenarios, 58,60 pictorial information or visual maps, 53,60,62,66 video tutorials, 62 apps and software 47,58,69 .…”

“…Education was delivered both one to one 39–41,45,48–53,55,59,60,64,66,68,70,71 and in groups 42,54,56,60,67 . Techniques and tools included coaching, 41,48,49,66 role play, 54 teach‐back/show‐back, 53,60,66 group discussion, 58,60 dilemma scenarios, 58,60 pictorial information or visual maps, 53,60,62,66 video tutorials, 62 apps and software 47,58,69 . In only three interventions 58,60,62 was the educational material codesigned or pretested by either patients or relevant stakeholders.…”

Impact of Pharmacy Students on Elderly Patients’ Education in Proper Medicine Administration

“…Therefore, it is so important to ensure proper care and understanding, in particular for this group of patients. By introducing proper education, it is possible to help elderly patients take their medicines more efficiently [29]. It is confirmed that seniors often do not follow recommendations of the physician and pharmacist.…”