Most older adults have not had comprehensive medication review

Among older adults taking at least two prescription medications, just one in four had a comprehensive mediation review with their pharmacist, according to findings from the National Poll on Healthy Aging conducted by the University of Michigan.

“These results show the importance of continuing efforts by physicians, pharmacists, other health care providers, insurers and policymakers to help older adults understand the importance of medication reviews,” Antoinette B. Coe, PharmD, PhD, an assistant professor of clinical pharmacy at the University of Michigan College of Pharmacy, said in a press release.

Surveys within the National Poll on Healthy Aging are conducted in the KnowledgePanel (Ipsos Public Affairs, LLC), a nationally representative probability sample of households in the United States. Surveys are sent out two to three times each year to a sample of about 2,000 panel members aged 50 to 80 years.

Coe and colleagues sent the survey on medication use and comprehensive medication review with a pharmacist in December 2019.

Among respondents, 41% reported taking two to four prescription medications, and 23% reported taking five or more prescription medications.

Additionally, 52% of adults reported taking at least two nonprescription medications, including over-the-counter herbal medicines or nutritional supplements. Among adults who reported taking at least five prescription medications, 32% reported that they were also taking at least five supplements or nonprescription medications.

Researchers determined that those aged 65 years to 80 years were more likely to take at least five prescription medications and at least five nonprescription medications compared with adults aged 50 years to 64 years.

They also found that among those who reported taking at least two prescription medications, just 24% reported ever having a comprehensive medication review with a pharmacist. This proportion was similar among adults enrolled in Medicare Part D prescription drug plans, with 25% reporting ever having a comprehensive medication review, despite their insurance covering the review.

Among older adults who had reported having a comprehensive medication review, 75% had one in the last year.

Researchers found comprehensive medication reviews were more common among respondents who took at least five prescription medications than those who took two to four prescription medications (29% vs 21%).

Among older adults who did not report having a comprehensive medication review, 86% did not realize their insurance would cover it, and 85% of those enrolled in the Medicare Part D prescription drug plan reporting they were not aware it was covered by their insurance.

Among those who reported taking at least five prescription medications and never undergoing a comprehensive medication review, 43% indicated they were interested in having one.

In the press release, Preeti Malani, MD, director of the poll and a physician specializing in geriatrics and infectious diseases at Michigan Medicine, suggested older adults keep a list of all the prescription and nonprescription medications that they take, and a pharmacist can review the list and identify any potential drug interoperations or opportunities for patients to switch to lower-cost treatment options.

In addition, she said that it is important for patients tell their physicians or other health care providers about every medication they take.

“Not only may they spot potential risks, but the computer systems that they use to track your care might identify potential interactions,” Malani said.

References:

• National Poll on Healthy Aging. Survey Methods. https://www.healthyagingpoll.org/survey-methods. Accessed October 6, 2020.
• National Poll on Healthy Aging. Older Adults’ Experiences with Comprehensive Medication Reviews.
• Press release.