Patient behavior in medication management- Findings from a patient usability study that may impact clinical outcomes.

AIMS: Adequate medication management is a key condition to ensuring effective pharmacotherapy. However, it is well acknowledged that older people may encounter difficulties self-administering medicines in a correct manner.

METHODS: A mixed method pilot study was performed to investigate medication self-management in older and multimorbid patients with polypharmacy. The pilot study involved medication management tasks followed by semi-structured interviews in 20 patients. The tasks and interviews were based on the patients' individual medication plans, which had been prepared earlier by the pharmacy for each patient on basis of all their prescriptions.

RESULTS: The patients' self-reported medication management skills differed from their actual observed medication management performance. In addition, the routines and coping strategies that were used by the patients to deal with the complexity of their overall medication regimen were not in accordance with the medication plan and the instructions for use on the product labels. Issues were observed on all stages of the medication process which can be considered relevant to patient adherence, especially medication plan recall, product identification, product selection, product handling and product recognition in a Multicompartment Compliance Aid (MCA).

CONCLUSIONS: The pilot study suggest that medication management issues by older and multi-morbid patients remain widely undetermined and unrecognized in primary care. Further investigation and interdisciplinary collaboration will be required to resolve the user problems and ensure adequate patient adherence.