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Overlooked Medication Reviews for Older Adults Pose Patient Safety Risks

Medication discrepancies can pose a patient safety risk. However, nearly 80 percent of older patients are not receiving medication reviews, despite having coverage through Medicare Part D.

Older adults could have better medication management, yet most are missing out on medication reviews which can reduce patient risk and improve prescription costs, according to researchers from the University of Michigan.

Medication discrepancies have led to cases of adverse patient outcomes. Experts have found that incidences of medication errors have been associated with the death of nearly 7,000 to 9,000 people in the United States.

For over 15 years, Medicare Part D plans have covered medication reviews allowing patients to meet with a pharmacist who assesses all the medicine and supplements taken.

Medication reviews are needed to manage not just prescription medications, but also supplements and over-the-counter medication intake. After all, supplements and OTC medications can have risky interactions with prescriptions, the press release stated.

The study, published in The Journals of Gerontology: Series A, found that fewer than 21 percent of people over age 65 received a comprehensive medical review.

“Our study found that in older adults with health insurance, 77 percent are on two or more prescription medications,” Antionette Coe, PharmD, PhD, lead study author and assistant professor of Clinical Pharmacy at the University of Michigan, stated in a press release.

“Of them, only 1 in 5 had received a comprehensive medication review, while over one-third were interested in a medication review in the future,” she added. “We also found that most older adults – about 83 percent were not aware that their prescription insurance may cover a medication review.”

Older patients on two or more prescriptions and in good health or with low incomes were less likely to have a medication review compared to other older adults who take similar numbers of medications but who are less healthy or have higher incomes.

Researchers also found that patients who take a greater number of medications and have difficulty affording them were more likely to have a medication review. Specifically, older adults who take five or more prescription drugs were much more likely than those who take between two and four drugs to have had a comprehensive medication review, the study showed.

In addition, patients who struggle to afford the cost of food had a higher likelihood of receiving a medical review.

“These results show a continued need to increase older adults’ awareness and education on the benefits of medication reviews,” Coe stated.

As cost continues to be one of the biggest challenges in medication adherence, provider and pharmacist should on helping patients increase affordability.

According to a 2021 survey, 27 percent of surveyed patients said their biggest barrier to medication adherence was the cost of their drugs.

Not achieving optimal medication adherence can lead to negative health consequences.

Providers should prioritize conversations about healthcare costs to ensure treatments are attainable for patients.

Cost and insurance coverage were the 11th most-discussed medication adherence topic for patient-provider communication, with only 29 percent of patients saying their clinician chatted with them about cost when prescribing a treatment plan.

Improving patient-provider communication is key to better medication management which could then lead to greater medication adherence and cost saving.

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