Barriers to Home-Based Medication Self-Management Among Older Adults with Multimorbidity: A Qualitative Study Guided...

To examine barriers to medication self-management among community-dwelling older adults with multiple chronic conditions (MCCs) and to provide evidence to guide medication safety and targeted nursing interventions.

A descriptive qualitative approach was used. Between July and September 2024, we recruited 14 community-dwelling older adults with MCCs from the geriatric medicine center of a tertiary hospital in the Inner Mongolia Autonomous Region. Face-to-face, semi-structured interviews were conducted. Empowerment theory served as the conceptual framework; data were analyzed using content analysis.

Barriers to home-based medication self-management among older adults with MCCs were grouped into three domains: resources, agency, and outcomes. Resource-related barriers included (1) lack of long-term medication plans and follow-up support; (2) Inadequate aging-friendly design of medication management tools; and (3) barriers to self-medication due to excessive family intervention. Agency-related barriers included (1) health decisions primarily based on religious beliefs; (2) symptom-driven medication behavior; and (3) low-burden oriented medication management tendencies. Outcome-related barriers included disconnect between home self-monitoring and clinical feedback.

Community-dwelling older adults with MCCs encounter multiple challenges that hinder effective home-based medication self-management, including limited structural support, reduced self-management capacity, and a lack of effective feedback systems. The findings indicate that medication management can be optimized through improved digital and assistive tools, enhanced interprofessional collaboration, and more effective, tailored health education. Future research should prioritize high-risk populations and develop individualized intervention strategies.