Practical Problems with Medication Use that Older People Experience: A Qualitative Study

Abstract

ObjectivesTo identify the practical problems that older people experience with the daily use of their medicines and their management strategies to address these problems and to determine the potential clinical relevance thereof.DesignQualitative study with semistructured face-to-face interviews.SettingA community pharmacy and a geriatric outpatient ward.ParticipantsCommunity-dwelling people aged 70 and older (N = 59).MeasurementsParticipants were interviewed at home. Two researchers coded the reported problems and management strategies independently according to a coding scheme. An expert panel classified the potential clinical relevance of every identified practical problem and associated management strategy using a 3-point scale.ResultsTwo hundred eleven practical problems and 184 management strategies were identified. Ninety-five percent of the participants experienced one or more practical problems with the use of their medicines: problems reading and understanding the instructions for use, handling the outer packaging, handling the immediate packaging, completing preparation before use, and taking the medicine. For 10 participants, at least one of their problems, in combination with the applied management strategy, had potential clinical consequences and 11 cases (5% of the problems) had the potential to cause moderate or severe clinical deterioration.ConclusionOlder people experience a number of practical problems using their medicines, and their strategies to manage these problems are sometimes suboptimal. These problems can lead to incorrect medication use with clinically relevant consequences. The findings pose a challenge for healthcare professionals, drug developers, and regulators to diminish these problems.

The knowledge, attitudes and beliefs of patients and their healthcare professionals around oral dosage form modification: A systematic review of the qualitative literature

“…36 The remaining four studies investigated the views of patients. [37][38][39][40] All of the studies involving HCPs were directly related to the topic of this review. [34][35][36] For the studies involving patients, one study directly addressed the topic of interest.…”

“…[34][35][36] For the studies involving patients, one study directly addressed the topic of interest. 38 Of the remaining three studies undertaken in patient cohorts, two investigated the problems experienced by patients in managing their medication 39,40 while one examined factors related to adherence. 37 For these three articles, a number of the findings addressed the topic of interest and these findings were included in the synthesis for the review.…”

“…37 For these three articles, a number of the findings addressed the topic of interest and these findings were included in the synthesis for the review. Modifications to facilitate fractional dosing were discussed in three of the studies, 37,39,40 while modifications for swallowing difficulties were the topic of consideration for four of the studies. [34][35][36]38 M A N U S C R I P T …”

“…All of the studies provided a clear statement of the aims of the research, used qualitative methodology appropriately, and employed an appropriate research design and recruitment strategy. Three of the studies did not provide sufficient detail about data collection 35,36,39 , with two of the studies not discussing data saturation 35,36 and one not providing detail about the use of a topic guide. 39 Four of the studies did not address reflexivity which relates to the researcher considering their role and potential bias.…”

“…Three of the studies did not provide sufficient detail about data collection 35,36,39 , with two of the studies not discussing data saturation 35,36 and one not providing detail about the use of a topic guide. 39 Four of the studies did not address reflexivity which relates to the researcher considering their role and potential bias. [34][35][36]39 Two of the studies did not provide sufficient detail about the data analysis process, particularly in relation to the number of researchers who performed the analysis.…”