Perspectives of Older Adults and Their Caregivers on Post‐Discharge Medication Management: A Qualitative Study

ABSTRACT Background and Aims Research to date has detailed numerous challenges and areas for potential harm surrounding medication management after hospital discharge for older adults, but few studies have directly detailed the concerns of older adults and their caregivers on these topics based on their lived experiences. Methods We conducted 34 structured post‐discharge interviews with older adults and their caregivers following hospitalization at the University of North Carolina Acute Care for Elders (ACE) unit using a questionnaire developed by an interprofessional working group within the division of geriatrics. All patients discharged home from the unit over a 1‐month period were contacted for an interview. Interviews were analyzed by three reviewers for themes and subthemes identified by a geriatric pharmacist, including medication communication, medication prescription process, and medication access. Results Patients were 78.9 ± 8.7 years of age, 64.5% women, and 74.2% White. Interviews were conducted with those who self‐reported responsibility for managing medications and included 15 patients, 15 caregivers, and 4 patient/caregiver dyads (34 total). Many participants felt that communication about medications lacked key information (62%, n = 21) or was unclear (29%, n = 10). Common concerns included potential side effects and administration instructions, including participants who expressed a lack of understanding of the duration of medication use or frequency for “as needed” medications. Several participants also reported issues with the prescription process for medication including prescriptions that lacked desired information (9%, n = 3) or were not properly sent to the patient's desired pharmacy (12%, n = 4). Fewer participants reported issues with medication access, including transportation (9%, n = 3), stock supply (9%, n = 3), and insurance/affordability (6%, n = 2). Conclusion Our study found that patients and caregivers frequently expressed concerns regarding communication about medications or obtaining their medications after discharge. Efforts are needed to enhance the process and reduce the risk of medication‐related harm in the period after discharge.