Medication use problems and factors affecting older adults in primary healthcare

Christina Malini Christopher; Ali Qais Blebil; K C Bhuvan; Deepa Alex; Mohamed Izham Mohamed Ibrahim; Norhasimah Ismail; Mark Cheong Wing Loong

doi:10.1016/j.sapharm.2023.08.001

Medication use problems and factors affecting older adults in primary healthcare

Res Social Adm Pharm. 2023 Dec;19(12):1520-1530. doi: 10.1016/j.sapharm.2023.08.001. Epub 2023 Aug 9.

Authors

Christina Malini Christopher¹, Ali Qais Blebil², K C Bhuvan³, Deepa Alex⁴, Mohamed Izham Mohamed Ibrahim⁵, Norhasimah Ismail⁶, Mark Cheong Wing Loong⁷

Affiliations

¹ School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Subang Jaya, Selangor, Malaysia. Electronic address: christina.christopher@monash.edu.
² School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Subang Jaya, Selangor, Malaysia; Department of Pharmacy, Al Rafidain University College, Baghdad, Iraq.
³ School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.
⁴ Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Subang Jaya, Selangor, Malaysia; Department of Geriatrics and Healthy Living, KIMSHEALTH, Thiruvananthapuram, Kerala, India.
⁵ Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha, Qatar.
⁶ Bayan Lepas Health Clinic, Ministry of Health, Malaysia.
⁷ School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Subang Jaya, Selangor, Malaysia.

PMID: 37574369
DOI: 10.1016/j.sapharm.2023.08.001

Abstract

Background: As the largest demographic group utilizing primary healthcare facilities, older adults often face the challenge of managing multiple chronic illnesses, leading to numerous medications.

Objective: The present study aims to assess medication use problems among older adults and explore the factors affecting them in primary healthcare settings.

Methods: A mixed-method study was conducted to establish a baseline understanding of the perspectives and challenges faced by older adults, with regards to medication use. Translated Medication Use Questionnaire (MedUseQ), a patient-centered tool, was distributed to older adults above 60 in primary healthcare settings to assess their frequency of problems related to medication use. Fifteen semi-structured interviews were conducted to explore this topic in depth. Descriptive and inferential analyses were conducted with quantitative data. Interviews were transcribed verbatim, and thematic analysis was conducted. Quantitative and qualitative findings data were triangulated.

Results: The study involved 393 participants. The most common problems with regards to medication use were polypharmacy (55.4%), administration difficulties (48.4%), limited awareness about adverse drug events (47.3%), issues with adherence (46.5%), and accessibility to primary healthcare (42.7%). Approximately 55% were satisfied with the older adult-centered medication use services by pharmacist and doctors. The qualitative findings showed that major factors affecting medication use were forgetfulness, language barriers, lack of awareness, transportation problems, long waiting times, and multiple visits to healthcare facilities.

Conclusion: The findings of this study reveal that a significant proportion, around 50%, of the older adult population face challenges with medication use in Penang. These difficulties mainly stem from medication administration, adherence, accessibility, polypharmacy, and inadequate medication knowledge. The qualitative analysis further highlighted several factors that contribute to such medication-related problems. Given the rapidly aging Association of Southeast Asian Nations (ASEAN) population, it is essential to devise effective solutions and strategies to tackle medication use-related issues among older adults.

Keywords: Challenges; Community pharmacies; Health clinics; Issues; Services.