Understanding older adults' medication decision making and behavior: A study on over-the-counter (OTC) anticholinergic medications

Holden, Richard J.; Srinivas, Preethi; Campbell, Noll L.; Clark, Daniel O.; Bodke, Kunal; Hong, Youngbok; Boustani, Malaz; Ferguson, Denisha; Callahan, Christopher M.

doi:10.1016/j.sapharm.2018.03.002

Cited by 30 publications

(23 citation statements)

References 66 publications

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“…To analyze card sort data, we used a descriptive method demonstrated in another study where card sort data were intended to probe the participants further and supplement interview and observation data [39]. We calculated the percent of participants sorting each of the eight information cards into "low," "medium," and "high" categories.…”

Section: Resultsmentioning

confidence: 99%

Health information management practices in informal caregiving: An artifacts analysis and implications for IT design

Holden

Karanam

Cavalcanti

et al. 2018

International Journal of Medical Informatics

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Introduction: Unpaid informal caregivers of adult care recipients, including persons with dementia, experience multiple unmet information needs and information management challenges. Objectives: To understand the current personal health information management (PHIM) practices in informal caregiving for adults with and without dementia. Methods: Semi-structured interviews were performed with ten informal caregivers-half of whom were caring for persons with dementia-and four formal caregivers at an adult day service. Interviews centered on a paper-based tool distributed by the day service, the CARE Kit, permitting an artifacts analysis of the tools used by participants for PHIM. Qualitative thematic analysis was applied to interview data. Results: Caregivers' PHIM practices aimed to support daily care management and decisionmaking on behalf of care recipients, through: 1) information acquisition and integration across multiple sources and records; 2) information maintenance, updating, and use over time; and 3) information sharing and communication with healthcare professionals and other family caregivers. Participants reported advantages and challenges of their PHIM practices and tools, including fitting PHIM into their daily lives, managing PHIM-related cognitive workload, the functionality of PHIM tools, and the dynamic, longitudinal nature of PHIM. Conclusion: The study produced a number of implications for caregiver health information management information technology (CHIM IT), based on findings about the nature of caregivers' practices for managing information for adult care recipients. We present CHIM IT requirements related to privacy and security, customization and flexibility, ease of use, credibility and sensitivity, situation awareness, information integration, delegation and shared use, updating and maintenance, archiving and versioning, communication, agency and information access, and validation.

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Section: Resultsmentioning

confidence: 99%

Health information management practices in informal caregiving: An artifacts analysis and implications for IT design

Holden

Karanam

Cavalcanti

et al. 2018

International Journal of Medical Informatics

Self Cite

View full text Add to dashboard Cite

show abstract

“…A critical factor at the in-store pharmacy is the pharmacist’s perceived and actual availability to speak, in person and by phone (#11). Holden and colleagues [ 80 ] observed that shoppers sought product information primarily, if at all, from packaging and more rarely (10% of shoppers) from a pharmacist. The ‘embarrassment and ignorance that it was appropriate to seek information from pharmacists’ reported in 1996 [ 81 ] may still be widespread.…”

Section: Participant Roles and Relationships Activities And Actiomentioning

confidence: 99%

Communicative and Discursive Perspectives on the Medication Experience

Glinert

2021

Pharmacy

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Taking the ‘medication experience’ in the broad sense of what individuals hear and say about their medication, as well as how they experience it, this paper explores diverse research on medication information available to patients and their modes and capacities for interaction, including personal circles, doctors and pharmacists, labeling and promotion, websites, and the patient’s own inner conversations and self-expression. The goal is to illustrate, for nonspecialists in communication, how the actors, messages, mediums, genres, and contextual factors within a standard ethnographic and social semiotic model of discourse and communication are operating, not always effectively or beneficially, to mediate or construct a patient’s medication experience. We also suggest how disparate insights can be integrated through such a model and might generate new research questions.

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“…[51][52][53][54] A recent study examining older adults' medication decision making and behavior in regards to the use of anticholinergic over-the-counter medications found that while seniors were concerned about adverse drug events, they were not aware of age-related risk associated with the use of anticholinergic medications. [55] Anticholinergic agents are used at end-of-life (EOL) for relief of nausea in those with a vestibular component and more commonly, to provide symptomatic relief of excessive secretions. However, data is lacking to support the use of these drugs for this latter indication.…”

Section: Deprescribingmentioning

confidence: 99%

Assessing Anticholinergic Effects in Older Adults

Lisi¹

2021

Update in Geriatrics

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Anticholinergic medications are widely used in older adults and are a common source of adverse events in this population. Common drug classes include antiarrhythmics, antidepressants, antiemetics, first generation antihistamines, urinary incontinence antimuscarinic agents, antiparkinsonian agents, antipsychotics, antispasmodics, and skeletal muscle relaxants. These drugs have been associated with delirium, cognitive impairment, sedation, dizziness, falls, fracture, constipation, urinary retention, blurred vision, tachycardia and dry mouth. If possible, these drugs should be avoided in older adults or less toxic agents within the class should be utilized. This chapter will explore the mechanism of action of anticholinergic drugs at both the cellular and organ system level; discuss how to assess for anticholinergic drug burden; list medications with anticholinergic effects as identified in the Beer’s criteria on potentially inappropriate medication use in older adults; review anticholinergic drug–drug interactions; describe contraindications to the use of anticholinergic agents; and explore practical considerations such as the availability of these substances in nonprescription medications, their use at end of life and deprescribing.

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Understanding older adults' medication decision making and behavior: A study on over-the-counter (OTC) anticholinergic medications

Cited by 30 publications

References 66 publications

Health information management practices in informal caregiving: An artifacts analysis and implications for IT design

Health information management practices in informal caregiving: An artifacts analysis and implications for IT design

Communicative and Discursive Perspectives on the Medication Experience

Assessing Anticholinergic Effects in Older Adults

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