Talking medication self-management for older adults with the U of M
People 65 years of age and older take prescribed medications more frequently than any other age group in the United States. With most older adults taking several medicines to treat chronic illnesses each day, it is important they stay informed on how to effectively and safely use medication.
Brian Isetts, Ph.D., RPh, BCPS, with the University of Minnesota College of Pharmacy and the Minnesota Northstar Geriatrics Workforce Enhancement Program (GWEP), discusses how older adults can confidently manage their medications.
Q: How does age affect a person's effective and safe use of medications?
Isetts: Physiological age-related changes can affect the body’s ability to absorb, distribute, metabolize and excrete medications. Physical changes related to eyesight, mobility, cognition and activities of daily living can also affect use of medication in older adults. From a socioeconomic perspective, factors such as social isolation or lack of a support network, a fixed budget that limits finances, capacity to understand complex medical language and access to or use of technology can inhibit their effective and safe use.
Q: What is medication self-management?
Isetts: Medication self-management allows older adults to take a more active role in the medical routines that impact their everyday lives. Successfully self-managing medications typically includes establishing habits, adjusting routines, setting reminders and tracking medication usage.
Q: What is a medication self-management plan?
Isetts: Research evidence suggests that older adults and their families can benefit from a systematic framework for implementing a medication self-management plan that includes understanding four key elements: the intended use of each medication, the effectiveness of each medication, safety and side effects, and convenience of use. The benefit of this process is that anyone — a family member, healthcare professional or caregiver — can initiate and facilitate the process with the older adult regarding their medications. These steps can be referenced in GWEP’s Effective Medication Self-Management Toolkit, which offers a way to make sense out of each person’s use of routine.
Q: What are the benefits of medication self-management?
Isetts: Medication self-management can lead to better clinical outcomes, less stress for patients and their families as everyone can be comfortable knowing medications are appropriate and are being received and taken correctly, less money spent on related healthcare costs such as emergency room visits and hospital stays, and reduced illnesses and death due to fewer complications arising from uncertainties about an older adult’s medications.
Q: How do I know if my loved one is ready to self-manage their medication?
Isetts: In general, a person can manage medications on their own if they understand the four elements listed above for each medication — intended purpose, effectiveness, safety and usability. An older adult’s successful and continued ability to self-manage their medications is likely to result from the ongoing support of and shared decision-making with family members and their healthcare team. The Effective Medication Self-Management Toolkit contains a short Self-Efficacy Checklist so that individuals and family members can determine where they need more help from their healthcare team.
Brian Isetts, Ph.D., BCPS, FAPhA, is a professor at the College of Pharmacy and a pharmacist with over 25 years of experience working as a nursing home consultant and in community and institutional practice. He specializes in the scholarship of caring, specifically studying the outcomes of medication therapy management services provided in integrated, team-based care settings. His research focuses on working with the person, family and community empowering patients to improve confidence and shared decision-making in medication use.
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About the University of Minnesota College of Pharmacy
Founded in 1892, the University of Minnesota, College of Pharmacy is the only pharmacy school in Minnesota, with campuses in the Twin Cities and in Duluth. The College of Pharmacy improves health through innovative education, pioneering research and interdisciplinary practice development that attends to the diverse needs of the people of Minnesota and the world.
About the Minnesota Northstar GWEP
The purpose of the Minnesota Northstar Geriatrics Workforce Enhancement Program is to improve the health and healthcare of older adults across Minnesota. It is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS), the primary federal agency for improving health care for people who are geographically isolated and economically or medically vulnerable. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government. The Minnesota Northstar GWEP is also supported by the Otto Bremer Trust, the University of Minnesota Medical School and the Office of Academic Clinical Affairs.