Medication Use and Rural Seniors. Who Really Knows What They Are Taking?

Objective: To determine whether listings of current medications obtained from the office file of patients' attending physicians and the pharmacy record of patients' dispensing pharmacists corresponded to the actual use of medications in a group of non-institutionalized seniors residing in rural communities.

Design: In-home interviews followed by retrospective office chart and pharmacy database reviews.

Setting: Two rural communities in southern Alberta with populations of less than 7000 people.

Participants: Twenty-five patients aged 75 years or older residing in the study communities, eight family physicians, and four dispensing pharmacies.

Main Outcome Measures: Number of currently consumed prescription drugs, currently consumed over-the-counter (OTC) drugs, and stored or discontinued prescribed medications; knowledge of medications (prescribed, OTC, and stored) by family physicians and pharmacists; and number of prescribers or dispensing pharmacists.

Results: Patients took a mean of 56 prescribed medications, took a mean of 3.5 OTC medications, and had a mean of 2.0 stored or discontinued medications. Attending family physicians and primary dispensing pharmacists typically knew of only some of their patients' entire regimen of medications.

Conclusions: Misinformation about medication consumption by seniors was common among health care providers. Undertaking routine medication reviews (with emphasis on OTC use), asking specific questions about actual consumption, encouraging use of one prescriber and one pharmacist, discouraging storage of discontinued medications and reducing use of medication samples should be of benefit.