Older adults using an interactive, multi-drug electronic pillbox that beeps when it's time to take each medication, and announces the number to take and how, were significantly less likely to miss prescribed doses than when not using the box, according to a study that will be presented here at the American Geriatrics Society's 2008 Annual Scientific Meeting on May 1. Among older people, drug-related health problems are fairly common, though under recognized, according to a second, related study, which will also be presented May 1 at the meeting.
The Society's annual meeting, which runs from April 30 to May 4, is the premier conference on aging research.
Ensuring that older adults, who are often prescribed medications, take their drugs as directed can be difficult -- and potentially hazardous. Some research suggests that more than 10 % of older adult hospitalizations are attributable to medication non-compliance.
In the first study, researchers at the University of Maryland School of Pharmacy monitored the medication compliance of older adults -- all of whom took at least four prescription drugs, often multiple times per day -- for three weeks. The researchers then gave each of the seniors a MedSignals interactive, electronic, multi-drug, multi-dose pillbox. The commercially available, programmable, "talking" pillbox includes a separate compartment for each drug, and holds a month's supply of medications. The pillbox beeps when it's time to take a medication, indicates which compartment the appropriate pill is in, and displays, on a screen, the number to take. When the compartment is opened, the pillbox repeats the number of pills to take, and specifies other important information regarding how the drug should be taken - as prescribed and programmed into the device. In the study, the pillboxes were programmed to send electronic reports on which drugs were taken, how often, and when, via phone line, to the researchers. (The commercially available boxes can be programmed to send patients, their healthcare providers and caregivers this information.)
When the older adults used the pillbox, they were significantly more likely to take their drugs as prescribed than when they didn't use the pillbox, the researchers found. Moreover, the difference in compliance rates increased with the number of doses prescribed daily. When they didn't use the pillbox, for example, adults who were prescribed multiple doses took an average of one pill fewer each day than when using the boxes. When using the boxes, older adults were also less likely to miss all doses on a given day - 6% of the seniors did this when using the box compared with 12% when not using it.
In the second study, researchers at Yale University School of Medicine interviewed more than 150 older adults taking five or more medications, asking them, among other things, if they had experienced any of the 20 most commonly reported drug side effects. The researchers also reviewed the adults' medical records to determine both whether their healthcare providers had noted any of these possible medication side effects in their records over the preceding year, and whether these clinicians had made changes in the adults' drug regimens as a result.
More than 90% of the adults reported experiencing one or more of the adverse effects to a degree that was at least "mildly bothersome." These adverse effects included mood changes, insomnia, impaired balance, fatigue, and dizziness. More than a third of these older adults attributed at least one of these symptoms to a medication. While more than 70% of the adults' healthcare providers documented one or more such symptoms in their patients' records, only 13.4% of the medical records mentioned drugs as a possible cause of or contributor to the symptoms. When the clinicians did note that the symptoms could be drug-related, 64% took steps to address the problem, usually by lowering the dose of the suspect drug or discontinuing it, the researchers found.
"These findings underscore the need to develop systematic approaches to identify possible drug-related symptoms and modify medications in response to identified symptoms," reports lead researcher Joseph V. Agostini, MD, an Assistant Professor of Medicine in Yale's Section of Geriatric Medicine, and colleagues.
About AGS
Founded in 1942, the American Geriatrics Society is a nationwide, not-for-profit association of geriatrics health care professionals dedicated to improving the health, independence and quality of life of all older people. The Society supports this mission through activities in clinical practice, professional and public education, research and public policy. With an active membership of over 6,700 health care professionals, the Society has become a pivotal force in shaping attitudes, policies and practices in geriatric medicine.
American Geriatrics Society
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