Voices of Polymedicated Older Patients: A Focus Group Approach

Abstract

Polypharmacy in older adults is frequently associated with incorrect management of medicines, which causes drug-related problems and, subsequently, poor health outcomes. Understanding why older adults incorrectly manage their medicines is fundamental to health outcomes, however, it is an issue that remains poorly explored. The aim of this study is to examine older people’s perceptions, attitudes, beliefs, and concerns in the central region of Portugal. Thirteen focus groups with sixty-one older adults taking five or more prescription medicines were conducted to explore older patients’ perceptions and beliefs about and management of their medication. Sampling was conducted until theme saturation had been achieved. Transcripts were coded and data were obtained using the NVivo qualitative data-analysis software programme. Older adults recognise the importance of medicines for ensuring healthy ageing. Owing to a lack of literacy, however, they frequently commit medication mistakes and compromise their health outcomes. Promoting the literacy and empowerment of older patients, as well as strengthening the relationship between health professionals and patients, is crucial when it comes to addressing drug-related problems and improving health outcomes.

Health professionals perception and beliefs about drug- related problems on polymedicated older adults- a focus group study

“…Our study demonstrated that media, websites and even patients' peers frequently gave patients "a false awareness of knowledge about medicines and because of that, patients tend to pressure HPs to obtain the products that they wish, and not what they need [18,19]. A recent FG study [20] observed that older patients trust in HPs, and believed that they play a determinant role to ensure the correct managing of medicines and decreasing DRPs. However, older adults also admitted that sometimes they decide not to comply with the therapeutic regime, due to influences of family and friends, television commercials, fear of an adverse reaction, etc., and they do not share their decision with health professionals [20].…”

“…A recent FG study [20] observed that older patients trust in HPs, and believed that they play a determinant role to ensure the correct managing of medicines and decreasing DRPs. However, older adults also admitted that sometimes they decide not to comply with the therapeutic regime, due to influences of family and friends, television commercials, fear of an adverse reaction, etc., and they do not share their decision with health professionals [20]. These observations are following our study since HPs perceived that older adults hide a considerable amount of information regarding the adaptation of the therapeutic regimen according to friend opinion and the consumption of herbal products.…”

“…These observations are following our study since HPs perceived that older adults hide a considerable amount of information regarding the adaptation of the therapeutic regimen according to friend opinion and the consumption of herbal products. Both HPs and patients [20] perceived that: (i) the influence of friends and television advertisements potentiate the consumption of supplements and other products, such as herbal products, which might prone them to quit their prescription medicines; (ii) the lack of knowledge of older patients and the absence of caregivers to help with the management of medicines improve both medication errors and poor compliance with consequently poor health outcomes; (iii) Because older patients recognize their medicines by color and shape, the lack of standardization of dosage forms, color and packaging, the change of trade mark drugs for generic drugs or changes of generic drugs holders, is enough for older adults to commit treatment duplication errors when they handle generic medicines. This observation was found in a previous study [21], (iv) older patients attach great value to their medicines, however, when they take many medicines, they weigh the risks and benefits and might stop taking some, (v) older patients trust in their HP, but they believe that there is no need to share the use of other products (like OTC) with the GPs; this purposeful omission of information influences treatment efficacy and makes the detection of DRPs difficult.…”

Acceptance of Pharmaceutical Services by Home-Dwelling Older Patients: A Case Study in a Portuguese Community Pharmacy

“…The main factors associated with these DRPs were forgetfulness, the cost of medicines, and the disfavor of some pills/pathologies by patients [ 11 ]. Previous studies have also pointed out that economic factors and the lack of knowledge of patients are preponderant factors in the lack of therapeutic adherence [ 3 , 11 , 23 , 24 ]. Some participants also pointed out the fear of an adverse reaction as a relevant factor in poor compliance.…”

The Use of Antidepressants, Anxiolytics, Sedatives and Hypnotics in Europe: Focusing on Mental Health Care in Portugal and Prescribing in Older Patients

“…The prescription of these drugs for older patients raises important concerns, as ageing and multimorbidity are usually associated with polypharmacy, where older patients take multiple medicines for long periods of their lives [ 18 , 19 , 20 ]. The use of multiple medications contributes to an inappropriate use of medicines, which can interfere with the effectiveness of treatments [ 18 ].…”