A Medication Management Program for Community Dwelling Elders

The social worker serving a senior subsidized housing project identified medication management problems among the residents. He consulted with community health nursing faculty and a local pharmacist to explore the severity of the problem and develop a solution. The nursing faculty reviewed the literature and identified common medication management challenges and interventions for elders living at home. The interdisciplinary team designed and carried out the study. Data collection instruments were based on previous studies. Twenty-four community dwelling elders over age 65 were recruited though fliers and individual contacts with the social worker. The faculty trained the senior nursing students and RN to BSN alumni on research methods and completion of a brief health assessment (BP, BMI, pain and general health history), and a medication profile (prescribed and over-the-counter) for each participant. Pharmacists reviewed the profiles and made recommendations for medication management based on pharmacy best-practice. The nursing students shared the recommendations with the elders and designed individualized medication regimens.

Medication management for this group of community based elderly participants with limited financial means is a complex issue. Social, economic, physiological and cultural issues impact the intent to adhere to medication schedules, ability to pay for and manage changes to medication regimens. The medication management program included: 1) nursing student visits to review medications; 2) periodic elder consultations with one RN volunteer; 3) the pharmacy works with the elders to offer the least expensive effective medications; 4) a pharmacy delivery service. The program development, process and outcomes will be presented.