Medication modification in a population of community-dwelling individuals aged 65 years or older

Abstract

Background: medication safety is a major public health challenge, particularly among older populations. Changing the medication's form may be inappropriate and may incur a risk of adverse effects.

Objectives: the objectives were to estimate the prevalence of medication modification and to identify factors associated with the practice of medication modification in community-dwelling older individuals.

Design: observational, cross-sectional, single-centre and epidemiological study.

Settings: community.

Subjects: outpatients and/or their accompanying persons, aged 65 years or over.

Methods: sociodemographic and clinical variables were recorded. It was also noted how the medication was taken, who administered the medications, the number of oral medications ingested per day, and whether or not the form of the medication was modified to facilitate administration. Descriptive analyses and logistic regression were performed.

Results: a total of 252 individuals were included in the study, with a mean age of 83 ± 7 years. Of these, 44 (17.5%) reported modifying their medication, either routinely (n = 36) or occasionally (n = 8). The factors independently associated with medication modification were the existence of psycho-behavioural disorders [odds ratio (OR) = 3.78; 95% confidence interval (CI) = 1.84-7.76; P < 0.0001], mobility difficulties (OR = 2.16; 95% CI = 1.01-4.62; P = 0.04), and the presence of dysphagia (OR = 3.23; 95% CI = 1.49-6.99; P < 0.0001).

Conclusions: this study indicates that main caregivers are more likely to engage in medication modification than nurses or the patients themselves. Factors associated with medication modification include swallowing difficulties and psycho-behavioural disorders. These findings provide new avenues that could help to mitigate this practice.

Keywords: community-dwelling; crushing medication; medication modification; older people.