title: Who really manages our patients' medications? A study of inner city adults over 40 years of age.
abstract: OBJECTIVE
  Primarily to determine how many of our adult patients receive significant assistance from another individual with medication management. Secondarily, to determine if the number of prescribed medications can be predictors of whether the patient receives significant assistance with medication management.
  
  
  METHODS
  Cross-sectional survey study.
  
  
  METHODS
  A level 3 patient-centered medical home family practice clinic in an inner city university hospital in Brooklyn, New York.
  
  
  METHODS
  Patients 40 years of age and older coming for a regular clinic visit to see the primary care physician.
  
  
  METHODS
  Administering the survey to the patients was the intervention. MAIN OUTCOME MEASURES: The number of patients who receive significant assistance with any phase of medication management was the main outcome measure.
  
  
  RESULTS
  Out of 143 patients surveyed, 61 patients (42.7%) received assistance with 1 or more phases of medication management; 38.5% (n = 55) of patients received help with phase 1 (ensuring that patients have medications at home). Of those 55 patients, 28 (50.9%) received help from family members, 22 (40%) received help from pharmacies, and 5 (9.1%) received help from home health aides or visiting nurses. Thirteen patients (9%) received help with phase 2 (arranging medications to help take them properly); 11 (84.6%) of them received help from family members. Twenty-three patients (16.1%) received help with phase 3 (reminding patients to take medications or handing them to the patient); 17 (73.9%) out of 23 received help from family members. There was a statistically significant trend (Mann-Whitney 2-sided test: P <0.001) showing a direct relationship between the number of medications and the need for assistance with 1 or more phases of medication management.
  
  
  CONCLUSIONS
  Many adult patients receive help with 1 or more phases of medication management. Family members are the major source of assistance with medication management. Pharmacies also play an important role in making certain that patients have medications at home. Patients with a higher number of medications are more likely to receive assistance from others.
authors.forename: Madhavi
authors.initials: M
authors.lastname: Gavini
authors.forename: Eve S
authors.initials: ES
authors.lastname: Faber
authors.forename: Andrea
authors.initials: A
authors.lastname: Birnbaum
authors.forename: Richard
authors.initials: R
authors.lastname: Sadovsky
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004358:Drug Therapy / Q000379:methods*; D005190:Family; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D054539:Medication Therapy Management / Q000706:statistics & numerical data*; D008875:Middle Aged; D009519:New York City; D017063:Outcome Assessment, Health Care; D018802:Patient-Centered Care; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014505:Urban Population
chemical_list: D004364:Pharmaceutical Preparations