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Medication management among home-dwelling older patients with chronic diseases: Possible roles for community pharmacists

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The journal of nutrition, health & aging

Abstract

Objective

To describe medication management among home-dwelling older adults. These data should allow us to identify potential problems and to indicate target areas for community pharmacist intervention.

Design

Cross-sectional observational study.

Setting

Community pharmacies (n=86) in Belgium.

Participants

Home-dwelling older adults using at least one chronic medicine (n=338).

Measurements

Data on drug use were taken from the electronic pharmacy databases, while drug adherence was measured by pill count, self-report and estimation by GP and pharmacist. Drug knowledge and practical drug management capacity were assessed by patient interview and questionnaire, respectively.

Results

The study population (n=338) used a median of 5 chronic drugs per patient. Half of our sample (n=169) used psychotropic medication chronically, mainly benzodiazepines. In 100 patients (29.6%) at least one drug-drug interaction of potential clinical significance was observed. The overall mean adherence per patient was very high (98.1%), but 39.6% of individuals was underadherent with at least one medication. Seventy-six % of patients had an acceptable knowledge of the indication for at least 75% of their medication. In nearly 15 % of the study population cognitive impairment was suspected by the Mini-Cog Test. The participants reported several practical problems with drug taking; difficulties with vision (32.0%), blister opening (12.1%), tablet swallowing (14.8%), tablet splitting (29.7% [represents % of patients who have to split tablets]) and distinction between different drug packages (23.4%).

Conclusion

This study identified the following aspects of medication management by home-dwelling older adults that could be improved by pharmaceutical care sendces; (i) assistance of cognitively impaired patients, (ii) management of practical drug taking problems, (iii) DDI screening, (iv) drug adherence, and (v) chronic benzodiazepine use.

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Authors and Affiliations

  1. Pharmaceutical Care Unit, Ghent University, Ghent, Belgium

    Els Mehuys, L. Dupond, E. Adriaens, L. De Bolle, I. Van Tongelen, J. -P. Remon & K. Boussery

  2. Department of Geriatrics, Ghent University Hospital, Ghent, Belgium

    M. Petrovic

  3. Department of General Practice and Primary Health Care, Ghent University, Ghent, Belgium

    T. Christiaens

  4. Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium

    L. Van Bortel

  5. Pharmaceutical Care Unit, Ghent University, Harelbekestraat 72, B-9000, Ghent, Belgium

    Els Mehuys

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  1. Els Mehuys
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Correspondence to Els Mehuys.

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Mehuys, E., Dupond, L., Petrovic, M. et al. Medication management among home-dwelling older patients with chronic diseases: Possible roles for community pharmacists. J Nutr Health Aging 16, 721–726 (2012). https://doi.org/10.1007/s12603-012-0028-x

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  • DOI: https://doi.org/10.1007/s12603-012-0028-x

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