Medication safety in older adults: home-based practice patterns.
OBJECTIVE
To identify the current state of medication-taking practices of community-dwelling older adults on high-risk medications.


METHODS
Telephone survey of older adults filling prescriptions for warfarin, digoxin, or phenytoin from May 2, 2002, through June 30, 2003.


METHODS
The Pennsylvania Pharmacy Assistance Contract for the Elderly (PACE) Program, a state-run program providing prescription drug coverage for poor older adults.


METHODS
PACE members.


METHODS
Patients self-reported sources of information on current medications as well as home-based practices for organizing medication regimens.


RESULTS
Four thousand nine hundred fifty-five PACE members were interviewed. Thirty-two percent of the sample reported that they had not received any specific instructions about their medications, 35% reported that they received instructions from their primary care provider, and 46% indicated they received them from a pharmacist. Fifty-four percent of participants indicated that they used a pillbox for organizing their medications. Older adults prescribed warfarin were more likely to report receiving instructions than those prescribed digoxin or phenytoin.


CONCLUSIONS
A substantial proportion of older adults on high-risk medications do not recall receiving instructions for the use of their medications and do not take advantage of existing systems for organizing medication regimens. Improved patient education and delivery of medication organization systems are immediate opportunities to potentially reduce the risk of medication errors in older people.
Metlay
Joshua P
JP
Penn Program for the Reduction in Medication Errors, Center for Clinical Epidemiology and Biostatistics, Philadelphia, Pennsylvania 19104, USA. jmetlay@cceb.med.upenn.edu
Cohen
Abigail
A
Polsky
Dan
D
Kimmel
Stephen E
SE
Koppel
Ross
R
Hennessy
Sean
S
D000368:Aged / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology; D015331:Cohort Studies; D004077:Digoxin / Q000008:administration & dosage*; D005260:Female; D015438:Health Behavior; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006304:Health Status; D006701:Home Nursing / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D010414:Pennsylvania / Q000453:epidemiology; D010672:Phenytoin / Q000008:administration & dosage*; D011159:Population Surveillance; D011446:Prospective Studies; D012646:Self Administration / Q000706:statistics & numerical data; D014859:Warfarin / Q000008:administration & dosage*
D014859:Warfarin; D010672:Phenytoin; D004077:Digoxin