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ABSTRACT: Background
Older adults often take multiple medications, leading to a myriad of medication-related problems. Addressing these problems requires thoughtful approaches that align with patients' perspectives and experiences.Objective
To (1) identify and categorize medication-related problems from the patient perspective and (2) understand patient and clinician attitudes toward these problems and experiences with addressing these problems.Design
Qualitative, semi-structured interviews with patients and focus groups with physicians and pharmacists.Participants
Twenty older adults recruited from an academic medical center and from a community senior center; 14 primary care physicians and 6 pharmacists affiliated with an academic medical center.Approach
Hybrid deductive-inductive thematic analysis.Key results
Older adults identified a variety of medication-related problems that could be classified into four broad categories: (1) obtaining medications (e.g., problems with cost and insurance coverage); (2) taking medications (e.g., organization and remembering to take pills); (3) medication effects, including side effects and concerns over lack of effectiveness; and (4) communication and care coordination, including information related to medications. Many of the problems described by older adults were framed within the person's socioemotional context, including the impact of medications on interpersonal relationships, emotional wellbeing, and activities that add meaning and quality to life. In contrast, clinicians almost exclusively focused on discrete medication issues without reference to this larger context and expressed relatively little interest in learning more about their patients' perspectives.Conclusions
Older adults experience medication-related problems as inseparable from their broader life context. Incorporating the social and emotional context of medications and related communication into a problem-focused framework can guide clinicians in specific actions and interventions to address medication-related problems from the patient perspective.
SUBMITTER: Nicosia FM
PROVIDER: S-EPMC7080912 | biostudies-literature | 2020 Mar
REPOSITORIES: biostudies-literature
Nicosia Francesca M FM Spar Malena J MJ Stebbins Marilyn M Sudore Rebecca L RL Ritchie Christine S CS Lee Kirby P KP Rodondi Kevin K Steinman Michael A MA
Journal of general internal medicine 20191101 3
<h4>Background</h4>Older adults often take multiple medications, leading to a myriad of medication-related problems. Addressing these problems requires thoughtful approaches that align with patients' perspectives and experiences.<h4>Objective</h4>To (1) identify and categorize medication-related problems from the patient perspective and (2) understand patient and clinician attitudes toward these problems and experiences with addressing these problems.<h4>Design</h4>Qualitative, semi-structured i ...[more]