Understanding older adults' medication decision making and behavior: A study on over-the-counter (OTC) anticholinergic medications

Potentially inappropriate anticholinergic medications (including over-the-counter products), polypharmacy, and the existence of communication barriers among members of the interprofessional team frequently contribute to clinical complexity in older adults. We present the case of a frail 86-year old female from the perspective of a community pharmacist managing outpatient medications and transitions of care. CD’s past medical history is significant for dementia, multiple falls, recurrent urinary tract infections, depression, cardiac arrhythmia, macular degeneration, chronic pain, depression, and cerebrovascular disease.

Download Full-text

Understanding the Factors Influencing Older Adults’ Decision-Making about Their Use of Over-The-Counter Medications—A Scenario-Based Approach

Pharmacy ◽

10.3390/pharmacy8030175 ◽

2020 ◽

Vol 8 (3) ◽

pp. 175

Author(s):

Shweta Shah ◽

Aaron M. Gilson ◽

Nora Jacobson ◽

Apoorva Reddy ◽

Jamie A. Stone ◽

...

Keyword(s):

Older Adults ◽

Decision Making ◽

Older Adult ◽

Medication Use ◽

Wait Time ◽

Sources Of Information ◽

Over The Counter ◽

Adult Participants ◽

Potential Risks ◽

Harmful Effects

The potential risks of over-the-counter (OTC) medications are often aggravated in vulnerable populations, such as older adults. The elevated patterns of older-adult OTC medication use do not necessarily translate into a greater understanding of these medications or their safety implications. The objective of this study was to assess how older adults’ knowledge, beliefs, and attitudes inform their decision-making regarding OTC use. Situational interviews were conducted in three community pharmacies with 87 older-adult participants to capture how they intended to use an OTC medication. The interviews were transcribed and qualitatively analyzed, generating seven key themes: (1) medication use concerns; (2) following label instructions; (3) wait time until medication effect; (4) responses to medication not working; (5) decision to stop medication; (6) sources of information; and (7) safety implications. This study shows substantial variations in older-adult OTC medication use while providing insight on factors that influence older adults’ appropriate OTC medication use and, in some cases, the potential for harmful effects.

Download Full-text

MOBILE APPLICATION TO SUPPORT SAFER MEDICATION DECISION MAKING AND BEHAVIOR OF OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igy023.314 ◽

2018 ◽

Vol 2 (suppl_1) ◽

pp. 82-83

Author(s):

R J Holden ◽

P Srinivas ◽

N L Campell ◽

D O Clark ◽

K S Bodke ◽

...

Keyword(s):

Older Adults ◽

Decision Making ◽

Mobile Application ◽

And Behavior

Download Full-text

Older Adult Shopping Persona Types and its Impact on Over-the-Counter Medication Misuse

Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care ◽

10.1177/2327857920091046 ◽

2020 ◽

Vol 9 (1) ◽

pp. 124-128

Author(s):

Shweta Shah ◽

Ashley O. Morris ◽

Jamie A. Stone ◽

Michelle A. Chui

Keyword(s):

Older Adults ◽

Decision Making ◽

Older Adult ◽

Preliminary Analysis ◽

Over The Counter ◽

Medication Misuse ◽

Safe Medication ◽

Counter Medication ◽

Medication Selection ◽

The Relationship

Older adult selection and use of over-the-counter (OTC) medications is informed by a range of motivations and rationales-forming different older adult personas. Holden et al. (2019) categorized older adults seeking OTC medications into two personas: habit followers and deliberators. The goal of this paper is to 1) operationalize and expand on the persona types proposed by Holden et al. 2) use these definitions to characterize the types of older adult personas and 3) explore the relationship between over the counter medication misuse and persona type. Our preliminary analysis identified 3 persona types with differing rates of misuse: 1) deliberators (m=1.8 (range 0-3) instances of misuse), 2) habit followers- formal source dependent (m=0 instances of misuse), 3) habit followers- informal source dependent (m=2.1 (range 1-3) instances of misuse). Information about safe medication choices, provided by physician or pharmacist recommendation, was seen to be critical in safe decision-making about OTC medication selection and use.

Download Full-text