Seniors and Medication Adherence
It is no secret that prescription drug use is increasing among people of all ages. This is especially the case for those 65 and over. According to the CDC, three out of four seniors take two or more medications per day. Thirty-seven percent take five or more.
It is also no secret that misuse is a significant problem, especially among older adults. Fifty-nine percent take their medications improperly. Under-medicating (sometimes due to concern about cost), over-medicating (losing track of dosages taken, “catching up”), and taking medications at the wrong time of day are all problems. The result is staggering: medication non-compliance is the cause of 23% of nursing home admissions and 10% of hospital admissions. With the current focus on reducing hospital admissions and re-admissions, improvement in medication adherence has the potential to make a real impact.
Some of the ways we can improve medication adherence:
- A medication minder container (or “pill box”), available at nearly all drug stores, is an inexpensive alternative that helps to ensure that medications and dosages are right. They are available in a variety of sizes, hold a day’s, a week’s or a month’s supply of medications; most provide for up to four dosage times per day. A nurse, family member or pharmacist typically sets up the medications in the container. A medication minder, however, may not be an appropriate solution for someone with a cognitive deficit.
- Live phone calls, often part of a daily well-being check, can be used to provide reminders at dosage times.
- A home care aide/caregiver from a licensed agency can provide reminders, as well as assist with other activities of daily living.
- Smart phone applications, automated phone calls or text messages, when used with a medication minder, can provide reminders of dosage times.
- Electronic organizers combine the storage capacity of a medication minder with automated control of dosage times. Medications are dispensed and made available to the patient only at programmed dosage times, usually with an audible (and sometimes visual) alert. If the medications are not taken, they become inaccessible at the next dosage time, so over-medication becomes less likely and under-medication becomes easy to spot. Prices and capabilities of electronic organizers vary from relatively inexpensive standalone units to systems that issue alerts to a remote caregiver when dosages are missed and provide online tracking. Some can manage dispensing of “as needed” medications such as pain medications.
A medication adherence solution is particularly important
- after discharge from a hospital or nursing home rehabilitation stay, especially when new, unfamiliar medications and new regimens are prescribed or “as needed” medications, especially to manage pain, are prescribed;
- when chronic health conditions are present, especially when blood thinners, diabetes medicines, seizure medicines or heart medicine are prescribed;
- for someone living alone, particularly when there is a cognitive deficit; and
- when medication regimens are complicated.
Seriously consider taking action to address or prevent medication adherence issues before they become the cause of a hospital or nursing home admission. Look for a trusted adviser familiar with the alternatives to help guide the choice of the most appropriate and cost-effective solution.