Impacting health care: Older adults and OTC medications

Health care regimens for older adults often include the use of prescription and over-the-counter (OTC) medication. Among older adults at risk of a major adverse drug event, nearly half of the instances were because of concurrent use of an OTC and prescription medication.

Michelle Chui, an associate professor in the Social and Administrative Sciences Division, has been studying the idea that older adults and pharmacists should work together to help older adults recognize whether an OTC is safe to use, given his or her own complex health care situation.

Chui, Director of the Systems Approach to Medication Safety (SAMS) Research Laboratory, has received two research grants to study this topic. The first grant, funded by the UW-Madison School of Pharmacy, explored barriers that pharmacists face when recommending safe OTC choices for older adults. “We found that the physical distance between the OTC medication aisles and the prescription department, the lack of knowledge and information available to the pharmacist, and high time pressure limited the pharmacists’ ability to effectively triage an older adult’s concerns and make safe recommendations,” Chui said.

The second grant was funded by the UW Institute for Clinical and Translational Research (UW ICTR). Chui identified barriers in consulting pharmacists on OTC medication use from the perspective of the older adult. She found that the physical layout of the pharmacy appears to hinder older adults’ ability to select safe OTC medications. Additionally, despite rigorous FDA labeling guidelines, older adults had difficulty comparing the active ingredients of different OTC products (which may be due in part to cognitive and physical impairments).

The results from both studies helped the development of an intervention which includes a physical layout change to sensitize older adults to riskier OTC medications, a video link which allows older adults to quickly and easily ask questions of a pharmacist situated in the prescription department, and a triage tool which will help pharmacists efficiently help an older adult with questions. A larger research grant is currently being developed to evaluate the implementation and safety of the intervention in a number of Wisconsin community pharmacies.