1. Findings from Focus Groups of Geriatric Patients Regarding Medication Issues Kate Lynn Lapane, PhD Virginia Commonwealth University

2. Study Specific Aims To develop tailored print materials based on electronic medication history To develop tailored instructional videos To pre-test these interventions with versions in English and Spanish

3. Focus Group Methods Qualitative Research Method Semi-structured group discussions Facilitated by an experienced moderator Script was made up of open-ended questions to guide the discussion

4. Recruitment of Participants Community locations: – senior and subsidized housing developments – senior centers –Hispanic community agency Focus groups were held in these same community venues Participants received a $30 Walmart card and refreshments

5. Focus Group Participants 11 Total: All over age 65 and with low-incomes 3 groups of Spanish- speaking participants 4 groups of black participants 4 groups of white participants

6. Focus Group Topics Difficulties encountered taking medications Methods used to remember to take medications Conditions under which medication is skipped Medication use other than how it is prescribed How doctors talk to patients about medications Asking doctors and pharmacists about medications

7. Data Analysis Qualitative analytic method: immersion/crystallization Repeatedly listened to audio recordings and read transcripts to identify themes Transcript texts were coded using the qualitative data management software, NVivo

8. Trends, Themes, and Findings Patients assume their PCP knows about prescriptions from other doctors –“When you go to another specialist they [PCP and specialist] communicate, because you don’t go to the specialist unless your primary doctor tells you.“ Patients do not think they often forget to take their medicines –If they do forget, they do not double up; they wait until the next time –“The doctor told us not to try double up or some like that. Just stop and take in the next day, you know, like you normally do.”

9. Trends, Themes, and Findings Patients often make random and rationalized decisions to skip some medicines on certain days, or to regularly not take them as directed –“I take it regularly Monday, Wednesday, Friday, so I figure you know, if I skip or didn't take it at all that would probably harm me. But as long as I keep taking it regularly I figure it’s okay.”

10. Trends, Themes, and Findings Patients want information from the doctor about their medicines, but do not appear to be having much discussion with their doctors about medicines, risks, and benefits Patients do not seem to expect their busy doctors to provide them with more information “I’d like him to talk to me period. He comes in with his little laptop, and of course someone else is taking my blood pressure and all that stuff. He looks at that. You’re okay, and he’s out the office.”

11. Surprises in the Findings Few participants said side effects of medicines are problematic for them Use of sample medications is low Pharmacy information sheets are easy to read and well-received, even for those who did not know they can ask for large print Medication labels are not confusing Participants do not often save unused medications They do not share medications with spouse, though some knew people who do

12. Conclusions Participants commonly take their medicines in ways other than prescribed Participants are unaware of the dangers of taking medicines incorrectly Participants assume their PCP is aware of all the medicines their other doctors prescribe

13. Conclusions Findings will help: –Better understand older patients’ perspectives and behaviors –Pinpoint information gaps –Develop content and tailoring strategies for the DVD intervention in this study –Tailor future interventions