Medication management for older adults

How to understand your medication and get the most from your prescriptions

56% of individuals aged 85 and over take five or more medications, according to an NHS Health Survey for England. Peter Thnoia, Prescribing Pharmacist from NHS pharmacy service PillTime, explains how older adults can improve their understanding and management of their medications.

Managing your medication and making sure you take them correctly is the single biggest proven health intervention we are likely to make which can have a positive effect on our lives. For people taking multiple medications, this becomes more important, but in practice, is much more difficult. According to the World Health Organization (WHO), millions of people worldwide are affected due to errors in medication administration. This leads to adverse effects, hospitalisations and more serious consequences.

The importance of proper medication management cannot be overstated, as it directly impacts the effectiveness and safety of treatment regimens.

Challenges and risks of medication management

Around 20% of people in the UK take more than three medications to manage health conditions. The numbers are staggeringly large and when you consider many of these people will have 8 to 10 medications to organise, it is easy to see how it quickly becomes difficult to manage medications.

Leighton Humphreys
CEO of PillTime

When you have been newly diagnosed with a condition, your attention is fully focused on the fact something is wrong. During this time, it may seem easy to remember your medication details, if you are organised and able to find the time to prepare for the new normal. In many cases this is not what happens, and people struggle with this new regime whilst being on an emotional journey of being told something is wrong. It can quickly become overwhelming.

For people on long term medication, it becomes equally challenging as the repetitiveness leads to confusion.

Common problems older adults encounter include:

• Remembering what to take and when: Managing multiple medications often involves complex dosing schedules, which can lead to confusion and missed doses. This becomes more difficult when the outer packaging changes and only the label remains the same.
• Difficulties opening packages: Some medications come in packaging that is challenging to open, particularly for older adults or those with dexterity issues.
• Different schedules/times: Coordinating medications with varying administration times can be daunting, leading to errors in timing or missed doses on a regular basis.
• Vision/reading labels: Poor vision or small print on medication labels can make it difficult for people to read dosage instructions and warnings accurately.
  
  

Risks from prescription errors and mismanagement

Prescription errors, although rare, can have severe consequences. These errors may include incorrect dosages, drug interactions, duplications of therapy, or overlooking contraindications, which are specific situations in which a drug, procedure, or surgery should not be used because it may be harmful to the patient.

Such mistakes can lead to adverse drug events, hospitalisations, and decreased quality of life. Additionally, non-adherence to medication regimens contributes to treatment failure and disease progression. Changing medication due to the condition changing can lead to old and new medications being in the patient's home at the same time.

It's no wonder there is confusion after the appointment with the prescriber as unfortunately they are under pressure also, so have limited time to make sure the patient understands everything.

Benefits of better medication management

Improving medication management offers numerous benefits, including:

• By far, the biggest effect is enhanced treatment outcomes: By effectively managing your medications, you can maximise the therapeutic effects of your treatments. This can lead to better health outcomes and, importantly, an improved quality of life. The potential for a brighter, healthier future is within your grasp.
• Reduced side effects: Proper medication management minimises the risk of adverse drug reactions, which are harmful and unintended reactions to medications, and side effects, enhancing patient safety and wellbeing.
• Prevention of falls: Certain medications can cause dizziness or drowsiness, increasing the risk of falls, particularly in older adults. Effective management helps mitigate this risk.

It's important that patients who already have an increased risk of a fall, in particular the elderly, are aware of which medications can increase the risks of a fall. In many cases, just a single medication can increase your risk and multiple medications make this risk higher.

Peter Thnoia
Prescribing Pharmacist at PillTime

Minimising dose errors and mismanagement

There are several strategies that can help reduce dose errors and mismanagement:

Simple reminders and lists

Utilising medication reminder apps, pill organisers, or written schedules can help individuals stay organised and remember to take their medications on time. Simple calendars can really help here, which you can tick off each medication as its taken.

Pill dispensers

Automated pill dispensers are equipped with compartments for each dose, ensuring accurate dosing and reducing the risk of missed or double doses. Medication pouches are a highly effective dosette replacement solution. Online pharmacies like PillTime provide a free medication and sorting service.

Pre-scheduled medication packs

These have been in circulation for a very long time and are a great tool to help people organise their medication. Online pharmacies such as PillTime organise your medication into pouches sorted by the right doses for the right times and deliver them directly to your door for free. These systems organise your solid dose medications by day and time vastly improving the accuracy of medication being taken. The burden reduces on the patient who can then spend more time being pro-active to their health rather than concerned they have taken the right medication each day.

For our patients, the average number of medication items they take is eight, if over the age of 70. This may be different nationally as we help people manage multiple medications. The combinations we most commonly see are medications for cardiovascular health, neurodegenerative disease medications such as dementia and Parkinson’s and medication used to treat type 2 diabetes.

Peter Thnoia
Prescribing Pharmacist at PillTime

Other products and tools to help older adults manage their medications

In addition to the strategies mentioned above, there are a wide range of products and tools available to aid in medication management. These tools are designed to empower you, the patient, and give you more control over your health. With these resources at your disposal, you can confidently navigate the complexities of your medication regimen.

• Medication management apps: Smartphone apps allow users to set medication reminders, track adherence, and access medication information and refill options.
• Large print or talking medication labels: These labels feature enlarged print or audio capabilities, making it easier for individuals with visual impairments to read dosage instructions and warnings accurately.
• Medication synchronisation programs: Some pharmacies offer synchronisation programs, allowing patients to pick up all their medications simultaneously, simplifying the refill process and reducing the risk of running out of essential medicines.

By addressing common challenges, minimising dose errors, and utilising appropriate tools and strategies, we can all work together to navigate the complexities of medication regimens and improve overall older adult health and wellbeing. Embracing innovative solutions and fostering collaboration are critical steps toward achieving successful medication management practices and enhancing the quality of patient care.