A qualitative study to understand multimorbidity and polypharmacy through engaging an underserved minority elderly group

Date

2021

Authors

Poon, Ivy
Skelton, Felicia
Mbue, Ngozi
Bean, Lena
Guinn, Dominique
Creaque, Charles
Ndefo, Uche
Jemerson, Terica

Journal Title

Journal ISSN

Volume Title

Publisher

Wiley

Abstract

Introduction: Having multiple chronic medications increases the risk of adverse drug events (ADE) among elderly patients, particularly those residing in medically underserved communities. A gap still exists about medication-related problems (MRP) and intervention strategies for minority older adults, which is highly relevant to advance pharmacy practice in providing culturally appropriate services and reduce health disparities.


Research Question or Hypothesis: What is the perception of MRP by minority elderly patients with polypharmacy? What are the potential strategies to improve medication management?


Study Design: A qualitative study with a multi-disciplinary patient centered focus group


Methods: Patients were engaged based on the Patient-Centered Outcomes Research Institute (PCORI) engagement rubric for research. Patients (age 65 years or older) taking five or more medications were recruited from a historically Black community in Houston, Texas. Structured open-ended questions were adapted from the principles of the Asset-Based Community Development (ABCD) process to guide discussion on research questions. Meetings were recorded and transcribed verbatim. Codes were developed based on the socioecological model. The content analysis in Altas ti, Inc. Responses were categorized into codes by two investigators independently, cross-matched, and discussed to resolve discrepancies.


Results: The workgroup consisted of three patients, one caregiver, one physician, one nurse, three pharmacists, three health educators, and one social worker (n=13; 92% African Americans). The workgroup spent two one-hour sessions to discuss the research questions. Patient-level problems reported were medication complexity, forgetfulness, and lack of organization. A common theme related to health-system level problem was confusion regarding excessive prescriptions from multiple providers. Patients suggested creating medication list, medication wallet cards, using a medication reminder app, and bingo games related to standard labels on prescription bottles.


Conclusion: This study provides important insights into MRP experienced by minority elderly patients and ideas for potential strategies for future interventions.

Description

Abstract originally published in Journal of the American College of Clinical Pharmacy, 4(9), 1190–1256. English. Published Online 2021. https://doi.org/10.1002/jac5.1481

Keywords

Adverse drug events, Medically underserved communities, Advance pharmacy practice

Citation

This is an abstract that is available at: https://doi.org/10.1002/jac5.1481. Recommended citation: Poon, I., & Mbue, N. D. (2021). 2021 ACCP Virtual poster symposium. JACCP: Journal of the American College of Clinical Pharmacy, 4(9), 1190–1256. This item has been deposited in accordance with publisher copyright and licensing terms and with the author’s permission.

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