Feasibility,Acceptability,and Preliminary Efficacy of a Medication Intervention for Older Adults

Abstract

Interventions to address polypharmacy and improve adherence are insufficient for community-dwelling older adults. To examine the feasibility, acceptability, and preliminary efficacy of a tailored medication management intervention (TIMM) to decrease inappropriate polypharmacy and improve medication management in community-dwelling older adults. We completed a single-blind, parallel-group randomized controlled trial. The intervention group received TIMM, including a comprehensive medication review by a pharmacist and an in-home intervention by an occupational therapist. About 78.8% of participants completed the study (n = 26). TIMM participants adhered to treatment recommendations from the occupational therapist (94%) and pharmacist (58%). At 6 months, TIMM participants experienced a significant reduction in medication management barriers (p < .01) and improvement in performance (p < .01). No significant differences were found between groups in reducing inappropriate medications (p = .302) or adherence (p = .458). TIMM is a feasible and acceptable intervention for community-dwelling older adults. It reduces barriers to medication management and improves medication management.

Plain Language Summary

Is a personalized medication management program practical, well-liked, and helpful for older adults who live at home?

Why was the study done? Many older adults take several medications at the same time that can cause harmful side effects, falls, and confusion. Many older adults are also not able to take their medications correctly, which leads to more problems. Most programs to help older adults with their medications only focus on one medication or use the same solution for everyone, like giving out pillboxes. These programs usually occur in clinics and don’t always consider the person’s needs or home setup, where they usually take medication. What did the researchers do? The researchers developed a new program called TIMM (tailored intervention for medication management). During TIMM, a pharmacist and an occupational therapist work together with the older adult to reduce unnecessary medications and to help the older adult manage their medications more easily at home. What did the researchers find? Thirty-three older adults participated, and most completed the study. Participants used most of the occupational therapy recommendations, such as using pill organizers and alarm clocks, but followed fewer of the medication changes suggested by the pharmacist. TIMM helped older adults fix problems in their homes that made it hard to take medications and helped them perform better on medication tasks, such as reading labels and opening pill bottles. There were no significant differences between the TIMM group and the control group in reducing the number of unnecessary medications or taking medication correctly. One reason for this was that some doctors did not respond to the pharmacist about stopping or simplifying medications. What do the findings mean? TIMM is a feasible and well-accepted program that improves how older adults manage medications at home. More work was needed to improve collaboration with doctors and to test whether TIMM can reduce unnecessary medications and improve the ability to take medication correctly for more older adults.