Abstract
BackgroundOlder population often have multiple and complex needs that are consequently challenged by the presence of polypharmacy, adverse drug reactions and drug-drug interaction. We aimed to determine home medication management practices (MMP) and its associated factors among chronically ill older population of selected districts of Nepal.MethodsA community based cross-sectional survey was conducted among 386 chronically ill older individuals from selected areas of Nepal between April to September 2016. Appropriateness of MMP was assessed through scores of questions using interview method. Multivariate logistic regression analysis using potential variables from bivariate analysis were used to determine factors affecting MMP.ResultsThe overall home MMP was mostly inappropriate (80.1%). Most participants had multiple prescribers for single disease (202, 52.3%) and inappropriate medication storage (188, 48.7%). Though the majority of them had drug administration schedule (378, 97.9%), expired medicines were also used (2, 0.5%). Regression analysis showed less than one year duration of disease (odds ratio [OR] = 3.901, 95% confidence interval [CI] = 1.528 to 9.959, P = 0.004), 1–2 years duration of disease (OR = 2.415, 95% CI = 1.210 to 4.821, P = 0.012) and smokers (OR = 2.025, 95% CI = 1.036 to 3.956, P = 0.039) as the major factors affecting appropriate home MMP.ConclusionsThe home MMP was associated with duration of disease and smoking status among chronically ill older patients living in selected districts of Nepal. Proper counselling and monitoring of such patients might be necessary to improve the practice.
Highlights
Older population often have multiple and complex needs that are challenged by the presence of polypharmacy, adverse drug reactions and drug-drug interaction
Several other factors such as wrong storage condition of prescribed medications, omission of medication dose, wrong time and frequency of administration, wrong route of administration, lack of medication administration schedule, use of discontinued or expired medication are often seen as poor home management practices (MMP) in the older population [6]
It is crucial to understand about the MMP in older population in order to ensure that drugs maintain their potency through appropriate storage along with drug safety by avoiding a mix-up of drugs and minimizing the possibility of overdosing and wastage of resources [15]
Summary
Older population often have multiple and complex needs that are challenged by the presence of polypharmacy, adverse drug reactions and drug-drug interaction. We aimed to determine home medication management practices (MMP) and its associated factors among chronically ill older population of selected districts of Nepal. Poor home management of medicines includes poor drug storage practices, lack of medication administration schedule, use of drugs from multiple prescribers, use of discontinued medicines, expired medications or medicines that are no longer needed and the use of over-the-counter medications which are not suitable for their condition [6]. Several other factors such as wrong storage condition of prescribed medications, omission of medication dose, wrong time and frequency of administration, wrong route of administration, lack of medication administration schedule, use of discontinued or expired medication are often seen as poor home MMP in the older population [6]. It is crucial to understand about the MMP in older population in order to ensure that drugs maintain their potency through appropriate storage along with drug safety by avoiding a mix-up of drugs and minimizing the possibility of overdosing and wastage of resources [15]
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