Medication management strategies used by older adults with heart failure: A systems-based analysis.
Robin S Mickelson, Richard J Holden
PMID 28901787WHAT IT FOUND
Older adults with heart failure used many medication strategies, including pillboxes, schedules, helpers, and rules for missed doses.
Some skipped doses for travel or comfort. Assess what patients actually do, not just whether they follow instructions.
Key findings
01Most participants used stable strategies to simplify or reorganise medication management, including marking bottles, adjusting schedules, and pre-preparing doses (90%, 55/61).
02Patients sometimes chose non-adherence to meet personal goals, such as skipping a diuretic while travelling or prioritising comfort (57%, 35/61).
03The healthcare system was a common constraint, but some system supports were appreciated, such as refill reminders and patient portals (92%, 56/61 said constraints; 51%, 31/61 reported supports).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in one region of the United States and only in older adults with heart failure, so it does not tell you what younger patients or other conditions do. Data came from a larger study, and only some measures were aimed at medication strategies, so less common strategies may have been missed. Patients were not followed over time, so the study cannot tell whether these strategies were safe or effective in the long term. The percentages describe what participants mentioned, not how often the strategies were used or whether they improved medication management.
Declared interests
The authors declared no conflicts of interest. The article is listed as supported by NIH extramural research.
The easy way to misread this
Do not read the percentages as proof that these strategies improve medication safety or health outcomes. They describe what participants said they used, and the study did not test whether the strategies worked.