MSTAR Student, Belinda Tang, and UCSF Pepper Investigate Medication Management Challenges Among Older Adults

Belinda Tang, MSTAR student, Edie Espejo, MA (Pepper Statistician), Mike Steinman, MD (Pepper Co-Director), and Matthew Growdon, MD, MPH (Pepper Scholar) published a research letter entitled "Cognitive, physical, and sensory deficits that can affect everyday medication use among older adults: A national view" in the Journal of the American Geriatrics Society.

Cognitive, physical, and sensory impairments are common among older adults and can affect their ability to use medications safely and effectively. Approximately one-third of older adults nationally have at least one measured deficit that can impact medication use. Among those who manage their medications independently, 31% have at least one of these impairments. 

To understand the extent of these challenges among older adults, the team conducted a study using data from the 2015 National Health and Aging Trends Study. They looked at a nationally representative sample of older adults who were taking prescription medications in the past month. They assessed impairments in cognition (possible/probable dementia), physical ability (grip strength and dexterity), and vision. They then categorized the number of impairments (0, 1, or ≥2) and analyzed them based on living arrangements and medication management practices.

In their analysis, they found that 35% of older adults living in the community have deficits that can impact medication safety and adherence. This population of 33 million individuals may not have built-in supports, so solutions such as blister packs, formal and informal support networks, and changes in prescribing practices can help improve medication management.

This study suggests that assessing patients’ cognitive, physical, and sensory abilities, as well as their social supports and living situations, can help clinicians prescribe medications safely, connect patients to appropriate support systems, and implement interventions to improve everyday medication use.