Results Summary

PCORI funded the Pilot Projects to explore how to conduct and use patient-centered outcomes research in ways that can better serve patients and the healthcare community. Learn more.

Background

Older people who have more than one health problem—such as diabetes, heart disease, and arthritis—may take many medicines every day. People who take their medicines correctly are less likely to get sick and go to a hospital or nursing home. Healthcare providers don’t always ask or understand how well older patients take their medicines.

Project Purpose

This study looked at what patients think, feel, and do when given new prescriptions, to help improve the chances that they will take the medicine the way they should.

Methods

The research team collected information from 29 English-speaking people who were age 60 or older, had three health problems, and were taking at least five medicines. Study participants had also just gotten a prescription for a new medicine.

All participants completed an electronic diary for 30 days to record what medicines they took each day, along with their thoughts and feelings about taking the medicines.

All participants also were asked in a survey about their personal characteristics, such as age or race, their health, the medicines they took, and when they took each medicine.

A nurse interviewed 15 participants at the start and end of the 30 days. The nurse asked participants to describe their experiences with managing their health and taking their medicines.

The research team summarized the findings from the electronic diaries, surveys, and interviews. The research team discussed their findings with patient experts and healthcare professionals and asked for their views on the results.

Findings

In the surveys and electronic diaries, many participants said they didn’t take their medicine the way it was prescribed because

  • They didn’t like the side effects, such as dizziness or digestion problems.
  • They didn’t always have money or insurance coverage to pay for their prescription.
  • Their pharmacy didn’t always have the medicine they needed.
  • It was hard for them to get to the pharmacy.
  • They didn’t know how to take the medicine properly.
  • They worried whether the medicine was right for them.
  • They worried that a new medicine would cause problems with other medicines they were already taking.
  • They forgot to take the new medicine because they were already taking so many others.

In the interviews, participants spoke about how their illnesses had changed their lives, including how they saw themselves and their relationships with other people. Participants wanted more time with their healthcare providers to talk about their symptoms, ask questions, and learn how to adjust their lifestyle as they learned how to live with their illnesses.

Limitations

The study was small and most participants were white. Also, patients who did not know how to use technology like the electronic diary may not have volunteered for the study. Findings may be different for people of different races and ethnicities or those who have trouble using technology.

Conclusions

Older patients who have multiple health problems find it hard to get their medicines and take them correctly. Patients may not know how to add a new medicine to the ones they are already taking. They may worry about how a new medicine is going to affect their daily life and health. Patients would benefit from guidance on how to discuss their questions and problems with healthcare providers.

Sharing the Results

The research team made instructional videos and other educational materials. They will test the educational materials in a separate study. The research team also wrote articles (see below) and gave presentations about what they learned from this study.

More to Explore...

Dissemination Activities

Through limited competition, PCORI awarded 25 of the 50 Pilot Projects up to $50,000 to support dissemination and implementation of their activities and findings through the PCORI Pilot Project Learning Network (PPPLN) funding. The deliverables listed below are a result of convenings and conferences supported by this funding, whose efforts align with the PCORI strategic goal of disseminating information and encouraging adoption of PCORI-funded research results.

Project Lead: Roxanne Vandermause, RN, CARD, CCM
Period: June 2015 to September 2015
Budget: $44,360

Presentations

"Advancing Quality and Relevance of Evidence for Patients" (51-54) and "Qualitative Methods in Patient-Centered Outcomes Research"
14th Annual Qualitative Methods Conference in Melbourne, Australia; April 2015

"Using Qualitative Methods in the Conduct of Patient-Centered Outcomes Research"


Project Lead: Joshua Jon Neumiller
Period: August 2015 to January 2016
Budget: $49,990

Created a video series to demonstrate patient-provider interactions

Presentations

"Patient-Provider Medication Discussion Toolkit" with patients, Nurse Case Managers at ALTCEW, Providence Visiting Nurses Association, and Aging and Long Term Care

"Citizen Scientists: Patient and Family Members on the Research Team" at the American Nurses Credentialing Center Research Symposium in 2015

Journal Citations

Related Journal Citations

Stories and Videos

Project Information

Roxanne Vandermause, RN, CARD, CCM
Washington State University
$265,493
Medication-Taking Preferences & Practices of Patients with Chronic Conditions

Key Dates

June 2012
June 2014
2012
2014

Study Registration Information

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State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: March 4, 2022