Interprofessional Medication Self-Management Program for Older Underserved Adults.

Area of Science:

• Geriatrics
• Primary Care Medicine
• Health Services Research

Background:

• Older adults face significant challenges in medication self-management, often leading to suboptimal disease control.
• Complex medication regimens and socioeconomic factors exacerbate these challenges in indigent populations.

Purpose of the Study:

• To evaluate the impact of an interprofessional medication self-management program on hypertension and diabetes control in older adults.
• To assess the effectiveness of a novel intervention in a primary care residency clinic serving a vulnerable patient group.

Main Methods:

• A 1-year quasi-experimental, pre-post study involving older adults (≥60 years) with uncontrolled hypertension (systolic blood pressure >140 mm Hg) and diabetes (A1C >7.5%).
• An interprofessional team (nurses, medical assistants, pharmacist, dietician, social worker, nurse technician) provided medication histories, conducted in-person interventions (motivational interviewing, regimen simplification), and offered post-appointment phone support.
• Data on medication fill histories, blood pressure, and A1C were collected and analyzed.

Main Results:

• The study included 50 patients (mean age 67 years, 78% female, 88% Black).
• Significant reductions were observed in mean systolic blood pressure (159.8 to 141.8 mm Hg, P < 0.001) and mean A1C (9.7% to 8.6%, P < 0.001) after 1 year.
• Blood pressure and A1C levels were significantly lower at all follow-up visits compared to baseline.

Conclusions:

• The interprofessional medication self-management initiative demonstrated significant improvements in systolic blood pressure and A1C.
• This program offers a viable strategy for enhancing chronic disease management in underserved older adult populations within primary care settings.