Informal caregivers' perspectives on health of and (potentially inappropriate) medication for (relatively) independent oldest-old people - a qualitative interview study

• Published in: BMC geriatrics 2018-07, Vol.18 (1), p.169-10, Article 169
• Main Authors: Pohontsch, Nadine Janis, Löffler, Antje, Luck, Tobias, Heser, Kathrin, Parker, Debora, Haenisch, Britta, Riedel-Heller, Steffi G, Jessen, Frank, Scherer, Martin
• Format: Article
• Language: English
• Subjects: Activities of daily living; Age; Aged, 80 and over; Aging; Caregivers; Caregivers - psychology; Dementia; Female; Focus groups; General practitioner; Geriatrics; Health Status; Humans; Informal caregiver; Interviews; Long term health care; Male; Older people; Patients; Potentially inappropriate medication; Potentially Inappropriate Medication List - standards; Potentially Inappropriate Medication List - trends; Prescriptions; Qualitative Research; Quality of Life - psychology; Surveys and Questionnaires
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-018-0849-5

Oldest-old persons frequently receive potentially inappropriate medication. Medication use takes place under the patients' informal caregivers' influence. We explored informal caregivers' perspectives on medication of (relatively) independent oldest-old persons to identify starting points for safer medication prescription/handling. In this exploratory qualitative interview study we interviewed 45 informal caregivers of 45 oldest-old persons (23 with potentially inappropriate medication/22 without potentially inappropriate medication). Interviews were recorded, transcribed and content analyzed (deductive/inductive coding). Interviewees had little knowledge about/influence on oldest-old persons' medication, but declared to monitor oldest-old persons' needs for assistance. They were unaware of the concept of potentially inappropriate medication but sometimes sensitive to substance dependency. Most informal caregivers were satisfied with the oldest-old persons' medication and viewed medication as increasing the patients' quality of life. Inadequate communication was found between informal caregivers and general practitioners. Influence of informal caregivers on (relatively) independent oldest-old persons' medication seems low. Stakeholders need to be aware that there is a transitional period where independency of oldest-old persons decreases and support needs increase which may be missed by (in-)formal caregivers or concealed by oldest-old persons. Monitoring patients' medication competencies; measures supporting communication between informal caregivers and health care professionals; provision of educational and support resources for informal caregivers and the acceptance of oldest-old persons' increasing assistance needs may increase medication safety.