Medication management at home in older patients with polypharmacy: In-depth interviews with home visits

Abstract

Background: Older patients with multiple non-communicable diseases (NCDs) usually require ≥5 concurrent medications or polypharmacy. Little is known about how patients manage medications at home. Objectives: This study qualitatively explored how older patients with polypharmacy manage medications at home in a primary care unit (PCU) in Pathum-Thani, Thailand. Methods: We conducted in-depth interviews in 2015 using a semi-structured questionnaire with 19 patients aged ≥60 years with polypharmacy and took photos of medication storage locations. The questionnaires asked about medication storage, sorting, and use. Transcripts were analyzed using thematic content analysis. Results: Of the 19 patients (mean age=69 years), 17 managed medications by themselves. The patients kept medications depending on their lifestyles. Newly received medications were kept separately from the remaining medications. Most patients used the remaining medications; yet, they did not look at the expiration dates. The remaining medications were kept, shared, thrown away, or returned to the PCU. All patients had a good attitude towards medications; yet, misunderstandings about medication administration and their outdoor activities were reasons for medication nonadherence. Conclusion: Older patients developed a system to store and organize medications at home. Management of remaining medications varied from patient to patient. Doctors should ask, not assume, elderly patients, to better understand how they manage medications at home. Future research should focus on if and how medication management at home affects medication adherence and health outcomes.