Findings from Focus Groups of Geriatric Patients Regarding Medication Issues

1
Findings from Focus Groups of Geriatric Patients
Regarding Medication Issues

• Kate Lynn Lapane, PhD
• Virginia Commonwealth University

2
Study Specific Aims

• To develop tailored print materials based on
  electronic medication history
• To develop tailored instructional videos
• To pre-test these interventions with versions in
  English and Spanish

3
Focus Group Methods

• Qualitative Research Method
• Semi-structured group discussions
• Facilitated by an experienced moderator
• Script was made up of open-ended questions to
  guide the discussion

4
Recruitment of Participants

• Community locations
• senior and subsidized housing developments
• senior centers
• Hispanic community agency
• Focus groups were held in these same community
  venues
• Participants received a 30 Walmart card and
  refreshments

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Focus Group Participants
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Focus Group Topics

• Difficulties encountered taking medications
• Methods used to remember to take medications
• Conditions under which medication is skipped
• Medication use other than how it is prescribed
• How doctors talk to patients about medications
• Asking doctors and pharmacists about medications

7
Data Analysis

• Qualitative analytic method immersion/crystalliza
  tion
• Repeatedly listened to audio recordings and read
  transcripts to identify themes
• Transcript texts were coded using the qualitative
  data management software, NVivo

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Trends, Themes, and Findings

• Patients assume their PCP knows about
  prescriptions from other doctors
• When you go to another specialist they PCP and
  specialist communicate, because you dont go to
  the specialist unless your primary doctor tells
  you. 
• Patients do not think they often forget to take
  their medicines
• If they do forget, they do not double up they
  wait until the next time
• The doctor told us not to try double up or some
  like that. Just stop and take in the next day,
  you know, like you normally do.

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Trends, Themes, and Findings

• Patients often make random and rationalized
  decisions to skip some medicines on certain days,
  or to regularly not take them as directed
• I take it regularly Monday, Wednesday, Friday,
  so I figure you know, if I skip or didn't take it
  at all that would probably harm me.  But as long
  as I keep taking it regularly I figure its okay.

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Trends, Themes, and Findings

• Patients want information from the doctor about
  their medicines, but do not appear to be having
  much discussion with their doctors about
  medicines, risks, and benefits
• Patients do not seem to expect their busy doctors
  to provide them with more information
• Id like him to talk to me period.  He comes in
  with his little laptop, and of course someone
  else is taking my blood pressure and all that
  stuff.  He looks at that.  Youre okay, and hes
  out the office. 

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Surprises in the Findings

• Few participants said side effects of medicines
  are problematic for them
• Use of sample medications is low
• Pharmacy information sheets are easy to read and
  well-received, even for those who did not know
  they can ask for large print
• Medication labels are not confusing
• Participants do not often save unused medications
  
• They do not share medications with spouse, though
  some knew people who do

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Conclusions

• Participants commonly take their medicines in
  ways other than prescribed
• Participants are unaware of the dangers of taking
  medicines incorrectly
• Participants assume their PCP is aware of all the
  medicines their other doctors prescribe

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Conclusions

• Findings will help
• Better understand older patients perspectives
  and behaviors
• Pinpoint information gaps
• Develop content and tailoring strategies for the
  DVD intervention in this study
• Tailor future interventions