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    More Older Patients Have Medication Troubles Than You Think

    What problems your older patients are having (and what you can do about it).

    A new study has tracked the rates at which older adults develop difficulty managing their medications and their finances and found that these problems can occur together.

    The research, “Difficulty Managing Medications and Finances in Older Adults: A 10-year Cohort Study,” analyzed data from the U.S. Health and Retirement Study (HRS). This is an ongoing national study in which people aged 50 and older are interviewed every two years to determine changes in disability, health, and wealth.

    The researchers looked at data from people 65 and older and followed them over 10 years, from 2002 to 2012. As part of the HRS, participants were asked “Do you have any difficulty managing medications?” and “Do you have any difficulty managing your money—such as paying your bills and keeping track of expenses?”

    Participants in HRS who reported trouble with either medications or finances at the start were excluded, leaving a sample size of 9,400 patients. The average age of the participants at the start of HRS was 74.1; 56.6% were female.

    Related article: Pharmacists take MTM to seniors in their homes

    Researchers found that 15.2% of participants developed difficulty managing medications, while 29.9% of participants developed difficulty managing finances over the 10-year study period. Women had a higher risk of developing difficulty managing medications than men (20.6% compared to 15.6%).

    Future planning may be needed

    These findings can help guide physicians and health-care professionals counsel patients and their families about planning for future needs. “While advanced planning in late life often focuses on health care and end-of-life preferences, our results highlight the need to counsel patients about preparing for the possibility of losing the ability to safely manage their medications and finances,” the authors stated.

    A variety of factors—including stroke, depression, and cognitive limitations— were found to affect the ability to manage medications and finances. “[The] findings highlight the need for clinicians to expand their focus beyond biomedical health, incorporating components of comprehensive geriatric assessment,” the authors state. “Taking care of older people requires a biopsychosocial-integrated view of wellbeing and health status.”

    Sunny Linnebur, PharmD, Clinical Pharmacy Specialist at the University of Colorado Hospital Seniors Clinic, told Drug Topics that, while there were no surprises in this research, “these data are very important in quantifying the overall need for medication and financial assistance for older adults in the community. The high percentage of older adults who appear to need assistance with medications or finances over time underscores the need for detection of these difficulties and resources to provide assistance to the affected older adults.” Women may be at a higher risk of developing difficulties than men, Linnebur added.

    Related article: A pharmacist's perspective on depression in the elderly

    Nienke Bleijenberg, RN, PhD, lead author of the study, told Drug Topics that the study findings were “a bit worrisome. Are health-care professionals aware of these numbers and are there sufficient resources to help these elders?” she asked. “Early identification and being aware of the risk factors is very important for all disciplines,” she added.

    The report also noted that because these results are based on self-reporting by the participants, the actual incidence of difficulty in managing medications and finances is most likely to be even higher. “Protective efforts, such as early identification, awareness, and preventive interventions are needed, as well as policy, research, and funding initiatives to reduce the consequences and burden of these serious impairments,” the authors stated.

    Up next: How the pharmacist can help

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