Self-medication with over-the-counter (OTC) drugs is an economical choice of treatment for common self-limiting illnesses. As more medications are made available as OTC drugs, and as the population of older adults continues to increase, a need arises to monitor how elderly individuals use these agents. The purpose of this study was to assess the self-medication practices with OTC drugs among older adults. The study took place in a city in North Carolina in apartments managed by the city's Housing Authority and a private physician's office. Participants included 39 adults ages 59 to 91. Respondents lived independently, used OTC drugs, and were responsible for their health care decisions. Conn's Self-Medication Practice Tool was used to assess symptoms the older adults were treating with OTC drugs; therapeutic categories of OTC drugs used; frequency of OTC drugs used; and the use of alcohol, prescription drugs, and caffeine. The respondents reported pain as the symptom most frequently self-treated with OTC drugs. Ninety percent of the respondents used pain medicine, and approximately two thirds (67%) of the respondents used at least one high blood pressure medicine. More than half of the respondents (59%) used caffeine daily, and 10% used alcohol. The researchers concluded that older adults might be unaware of the adverse risks associated with concurrent use of pain medicines, alcohol, high blood pressure drugs, and regular caffeine use. This makes it necessary for all nurses and other clinicians providing health care to older adults to intensify efforts to educate and guard these patients and ensure appropriate use of OTC drugs.

Poor adjustment to diabetes in older African American women may result from uncertainty, stemming from a lack of information about self-care activities, a complexity of self-care activities, comorbid conditions, and a lack of resources. This study evaluated a telephone intervention to reduce uncertainty (through problem-solving strategies, information, cognitive reframing, and improved patient-provider communication)--namely, to measure its effects on diabetes self-care and psychosocial adjustment. Sixty-eight older African American women were randomly assigned to an experimental group and a control group. The experimental group received the intervention for 4 weeks, and the control group received usual care. Psychosocial adjustment and self-care were measured in all participants at baseline and 6 weeks postbaseline. The experimental group reported increased participation in exercise (self-care component; p < .001) and improvement in psychosocial adjustment (p < .001). Thus, reducing the uncertainty related to diabetes self-care improves self-care exercise, as well as psychosocial adjustment.

A common health problem among the elderly with diabetes is the onset of depressive symptoms that can adversely affect self-care and control of diabetes. The study examined the relationships of gender, race, comorbid conditions, symptom distress, and functional status with depression in a sample (N = 55) of older adults with diabetes. Most participants were female and black; mean age was 73 years. Gender and symptom distress were the strongest predictors of depression, accounting for 53% of the variance in depression. Although the sample was reasonably high functioning with only moderate levels of symptom distress, these findings serve as an important reminder for nurses that even moderate levels of symptom distress may be an indicator of depressive symptomatology among older diabetic adults.