Successful management of long term chronic illness mostly depends on medication. The study objectives are: 1) to identify elderly patients' day-to-day medication challenges; 2) to access patients' medication knowledge including side-effects, interactions and consumption time; 3) to understand patients' sources of information for medication; and 4) to examine medication support needed/ available for patients. This study was conducted in two phases: first using focus groups and second using a questionnaire survey. 60 elderly Cardiovascular Disease (CVD) patients and caregivers participated in the study. In this paper we present the numerous problems faced by patients in their day-to-day medication management including medication adherence, forgetting medication, their side-effects, time of consumption, and interactions with diet. On comparing patients' requirements with the existing medication systems, our findings suggest that existing systems and research concentrate on few aspects like medication adherence, monitoring or reminders and do not address all the day-to-day management needs. This study endorses the need to develop a holistic solution using patient-centered and evidencebased design approach.