Study Outlines Successful Management of Medication

March 12, 2008

BLOOMINGTON, Ill.— As the proportion of older adults rises in the United States, a growing number of patients must learn to juggle multiple medications with potentially complex dosage schedules, while also facing age-related changes that may hamper their ability to manage medication.

Millions of people in the United States gamble with their health each day by not taking prescribed medications correctly. The World Health Organization predicts only 50 percent of patients typically take medicine as prescribed.

A study by Illinois Wesleyan University nursing faculty suggests health care professionals can look at an older patient’s lifestyle to understand whether they may be successful in managing their prescriptions and needed medications.

The IWU study results, which will be published in July in Nursing Science Quarterly, present characteristics of patients who successfully manage their medicine.  “There are certain features that seem to influence whether or not someone will manage their medicine well, which we call ‘living orderly’ or ‘aging well,’” said associate professor of nursing Kathy Scherck.

Scherck along with Susan Swanlund, assistant professor of nursing, and Sharie Metcalfe and Shelia Jesek-Hale, both associate professors of nursing, studied a group of older adults in order to assess what problems they might be having managing medicine on their own. “What we found surprised us,” said Swanlund. “We found a group of people who were all successful at self-management. This presented a possible guideline for healthcare providers to note who might do well, and conversely, who might need more assistance, with medication.”

According to the study, those who lead more orderly lives tend to be more successful with managing their medicine. “These people keep track of their lives, even if they are very busy,” said Scherck. “If they are successful with organizing their lives, they can be successful organizing their medicine.”

In the study, some patients developed fairly easy systems for taking the medicine, whether putting needed pills in the same location each day, or establishing “triggers,” or reminders to take medicine. “These people had established patterns that made self-management possible, and simplification was important as well,” said Scherck. “They had learned how to make their lives work, and felt that their medicine fell into a overall life plan.”

Part of that plan included flexibility. “There was a component of anticipation, planning what to do in case medication was forgotten,” said Swanlund. “There was not a sense of rigidity, in a way each successful plan was individualized into the life of the participant.”

The idea sounds simple, but the study also found aging well is more than establishing a consistent routine, it also means incorporating medicine into a positive outlook of health and living well. “The people who were doing well in the study have made medicine just one piece of their overall wellness,” said Metcalfe. “They have integrated medicine into their lives.”

The published study, which covers data collected from 2003-2004, represents phase one of the research, which is continuing with different populations. Swanlund is looking at how a “snow bird’ schedule affects medicine management. “I’m working with data from older adults who travel during the spring,” said Swanlund, whose data covers 19 adults from 11 different states who all journey to Florida in winter.

Jesek-Hale is expanding the research to a younger group, exploring how pregnant women manage their health, including use of pre-natal vitamins and pre-natal care during pregnancy. “This whole idea of developing your life with a positive and proactive approach seems to have a very big impact on living well, no matter your age or state of health,” said Jesek-Hale.

“Everyone knows they are supposed to take their medicine,” said Metcalfe. “We all know that’s what a healthcare provider wants to hear. If patients are asked, ‘Are you taking your medicine?’ The answer is generally yes, whether they do or they don’t. But providers ask about daily patterns, daily living, they could get a better idea of how patients are managing their lives, and how medicine plays into that picture.”

Contact: Rachel Hatch, (309) 556-3960