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Medication Management

55% of older adults do not take their medications as prescribed. Numerous prescriptions and over-the-counter medications, frequent prescription changes, and multiple prescribing physicians contribute to the complexity of managing medications and can lead to mistakes, dangerous side effects, or render the medication ineffective. 

 

Understanding Medications

Be informed - ask these questions about medications and go to a trusted source for additional information. 

 

Reconciliation and Review

Medication reconciliation is the process of comparing the medications that are currently prescribed with all prescription and over-the-counter medications being taken in order to identify discrepancies and interactions.

  • Whenever a new medication is ordered or changed, ask the physician or pharmacist to review all prescriptions, over-the-counter medications, and supplements being taken

  • Even if there are no changes in medications, have a doctor or pharmacist review them annually

  • Use a Medication List to keep track of medications and supplements, including doses and the purpose

  • Many apps are available to track medications and assist with medication management. Examples include:

 

Adherence

Adherence means taking medications as prescribed. People may not be adherent for a variety of reasons, and it is important to understand the reason in order to find a solution. Below are some causes for non-adherence: 

  1. Misunderstanding or mistrust of the medication, including not understanding the purpose or need for it

  2. Fear of side effects or medication dependency 

  3. Vision impairments that make it difficult to read pill bottles, differentiate between pills, or fill syringes

  4. Dexterity issues that make bottles or blister packs hard to open or eye drops difficult to administer

  5. Swallowing difficulties or a bitter medication taste 

  6. Memory and cognition problems such as forgetting to take a medication, when to take it, to order or pick it up from the pharmacy,  or that it was already taken and taking it again, as well as the inability to follow through on tasks

  7. Transportation challenges that make it difficult to get to the pharmacy

  8. Cost and the inability to afford the medication

 

Solutions and Strategies

  • Establish a routine around taking medications, and ensure the medication is visible and accessible

  • Reminders - remind in-person or by phone or use a reminder app or pill organizer with alerts

  • Find the right pill organizer - daily, weekly, monthly, easy-to-open, color-coded, large print, or with alerts.  A few specialty ones include MedMinder and Hero for alerts and Sagely, which has large boxes with a reminder app.

  • Try automatic pill dispensers such as Med-E-Lert or Hero Health

  • Ask the pharmacy if there are other packaging options such as pill packs

  • Have prescriptions delivered by the pharmacy or an online service such as Express Scripts or Blink Health

  • Speak to the physician or pharmacist about your concerns

    • Can the frequency or dosage be changed?

    • Is there a less expensive alternative?

    • Or one that has fewer side effects?

    • Can the medication be crushed or dissolved or is there another way to administer it?

  • Look into patient assistance programs to assist with paying for medications. These are offered by some states, pharmaceutical companies, and even online pharmacies such as RX Outreach.

  • Review prescription coverage, including Medicare Part D, and make changes during open enrollment

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