A Scalable, Multi-format Approach to Polypharmacy Education in Rural Older Adults: An Exploratory Pilot Study...

Background Polypharmacy poses significant risks for older adults, especially in rural areas where healthcare access may be limited. This exploratory pilot study assessed the feasibility and potential impact of two educational interventions aimed at supporting medication management among rural older adults. Methodology We conducted a comparative intervention study from July 2024 to October 2024. Rural adults aged ≥60 years taking medications participated in in-person sessions (n = 18) or received self-paced packets (n = 33). Both interventions used the WHO's Five Moments for Medication Safety framework. Pre- and post-surveys assessed knowledge, confidence, and medication management practices using REDCap. Statistical analysis included descriptive statistics and inferential testing to examine associations between polypharmacy status and medication management outcomes. Results Both interventions improved polypharmacy knowledge and management confidence. Inferential analysis revealed significant associations validating intervention targets: polypharmacy (>4 medications) was significantly associated with medication management difficulty (p = 0.011) and multiple simultaneous challenges (p = 0.024, odds ratio = 9.99). In-person participants' recognition of polypharmacy risks increased from 50% to 77.8%, while provider communication confidence rose from 88.9% to 94.4%. The self-paced packet achieved wider reach (94.4% more participants), with 100% reporting information was clear and relevant, and 93.9% feeling more confident discussing medications with providers. Groups differed significantly in age distribution (p = 0.002) but not in polypharmacy burden (p = 0.766). The packet format extended access by addressing barriers such as transportation, technology access, and mobility limitations, reaching 96.8% of participants outside the primary study county compared to 47.1% for in-person sessions. Conclusions Both interventions improved outcomes, but the self-paced packet demonstrated superior scalability and engagement. Statistical analysis confirmed that polypharmacy creates significant management challenges, validating targeted educational interventions. The packet's multi-format design (printed materials, USB drives, QR codes, web links) effectively reduced participation barriers and promoted equitable access, offering a promising model for rural health interventions.