Empowering older adults in medication safety

Background Older adults are at a heightened risk of experiencing adverse drug events due to polypharmacy and the use of potentially inappropriate medications. Enhancing the knowledge and self-advocacy skills of patients and caregivers regarding safe medication practices through educational intervent...

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Main Authors: Jennifer A. Stoll, Andrew D. Baumgartner, Laura A. Brady, Alexandria M. Wahler, Roopsy Kamboj, Robert G. Wahler, Ranjit Singh
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Health Literacy and Communication Open
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Online Access:https://www.tandfonline.com/doi/10.1080/28355245.2025.2476133
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author Jennifer A. Stoll
Andrew D. Baumgartner
Laura A. Brady
Alexandria M. Wahler
Roopsy Kamboj
Robert G. Wahler
Ranjit Singh
author_facet Jennifer A. Stoll
Andrew D. Baumgartner
Laura A. Brady
Alexandria M. Wahler
Roopsy Kamboj
Robert G. Wahler
Ranjit Singh
author_sort Jennifer A. Stoll
collection DOAJ
description Background Older adults are at a heightened risk of experiencing adverse drug events due to polypharmacy and the use of potentially inappropriate medications. Enhancing the knowledge and self-advocacy skills of patients and caregivers regarding safe medication practices through educational interventions is a critical strategy currently under investigation.Aims Using the Capability, Opportunity, & Motivation – Behavior (COM-B) model as a theoretical framework, this qualitative study aimed to assess how older adults perceived the ability of educational videos to promote self-advocacy and initiate patient-led medication management and deprescribing.Methods Utilizing a Community Based Participatory Research (CBPR) approach, focus groups were conducted (4 groups, n = 42) with community-dwelling older adults who participated in the development of the videos. The focus groups were held in a community setting and using the educational videos as a trigger, members were asked to evaluate the potential of these videos to promote behavior change around medication self-advocacy and specifically to encourage patient-led conversations addressing medication concerns with providers. The semi-structured questions were open ended and based on patient empowerment models and previous research assessing videos to increase knowledge and promote behavior change. Focus groups were recorded and transcribed verbatim. Data were initially analyzed deductively using the COM-B model of behavior change including capability, opportunity and motivation. It was then further categorized through a socio-ecological framework to accommodate the lived experiences and context of the individual.Results While capability and motivation were identified within the individual and interpersonal levels, members identified complex and multi-level barriers and facilitators to self-advocacy at each level in the socio-ecological framework: 1) Individual level: patient responsibilities, empowerment, and health literacy; 2) Interpersonal/Relationships level: patient and provider communication; 3) Systems: fragmentation, office visit time constraints, poor communication and lack of individualized health care; 4) Social and cultural: ageism, historical racism, and health system distrust. Videos were perceived to help with levels 1 and 2 only.Discussion Using a COM-B model mapped onto a socio-ecological framework, we identified variables to consider when assessing educational interventions for self-advocacy and patient-led deprescribing outcomes. While educational videos can potentially address Individual- and Interpersonal-level factors, overcoming higher-level factors (‘Systems’ and ‘Social and cultural’) will require interventions in the healthcare system and the broader community to overcome the identified challenges to patient empowerment.
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spelling doaj-art-facb30c03376491fbabdf5a552ac4ab52025-08-20T03:22:19ZengTaylor & Francis GroupHealth Literacy and Communication Open2835-52452025-12-013110.1080/28355245.2025.2476133Empowering older adults in medication safetyJennifer A. Stoll0Andrew D. Baumgartner1Laura A. Brady2Alexandria M. Wahler3Roopsy Kamboj4Robert G. Wahler5Ranjit Singh6Department of Family Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USADepartment of Family Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USADepartment of Family Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USADepartment of Family Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USAUniversity at Buffalo School of Public Health and Health Professions, Buffalo, New York, USADepartment of Pharmacy Practice, University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, New York, USADepartment of Family Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USABackground Older adults are at a heightened risk of experiencing adverse drug events due to polypharmacy and the use of potentially inappropriate medications. Enhancing the knowledge and self-advocacy skills of patients and caregivers regarding safe medication practices through educational interventions is a critical strategy currently under investigation.Aims Using the Capability, Opportunity, & Motivation – Behavior (COM-B) model as a theoretical framework, this qualitative study aimed to assess how older adults perceived the ability of educational videos to promote self-advocacy and initiate patient-led medication management and deprescribing.Methods Utilizing a Community Based Participatory Research (CBPR) approach, focus groups were conducted (4 groups, n = 42) with community-dwelling older adults who participated in the development of the videos. The focus groups were held in a community setting and using the educational videos as a trigger, members were asked to evaluate the potential of these videos to promote behavior change around medication self-advocacy and specifically to encourage patient-led conversations addressing medication concerns with providers. The semi-structured questions were open ended and based on patient empowerment models and previous research assessing videos to increase knowledge and promote behavior change. Focus groups were recorded and transcribed verbatim. Data were initially analyzed deductively using the COM-B model of behavior change including capability, opportunity and motivation. It was then further categorized through a socio-ecological framework to accommodate the lived experiences and context of the individual.Results While capability and motivation were identified within the individual and interpersonal levels, members identified complex and multi-level barriers and facilitators to self-advocacy at each level in the socio-ecological framework: 1) Individual level: patient responsibilities, empowerment, and health literacy; 2) Interpersonal/Relationships level: patient and provider communication; 3) Systems: fragmentation, office visit time constraints, poor communication and lack of individualized health care; 4) Social and cultural: ageism, historical racism, and health system distrust. Videos were perceived to help with levels 1 and 2 only.Discussion Using a COM-B model mapped onto a socio-ecological framework, we identified variables to consider when assessing educational interventions for self-advocacy and patient-led deprescribing outcomes. While educational videos can potentially address Individual- and Interpersonal-level factors, overcoming higher-level factors (‘Systems’ and ‘Social and cultural’) will require interventions in the healthcare system and the broader community to overcome the identified challenges to patient empowerment.https://www.tandfonline.com/doi/10.1080/28355245.2025.2476133Medication safetydeprescribingpatient-centered careolder adults
spellingShingle Jennifer A. Stoll
Andrew D. Baumgartner
Laura A. Brady
Alexandria M. Wahler
Roopsy Kamboj
Robert G. Wahler
Ranjit Singh
Empowering older adults in medication safety
Health Literacy and Communication Open
Medication safety
deprescribing
patient-centered care
older adults
title Empowering older adults in medication safety
title_full Empowering older adults in medication safety
title_fullStr Empowering older adults in medication safety
title_full_unstemmed Empowering older adults in medication safety
title_short Empowering older adults in medication safety
title_sort empowering older adults in medication safety
topic Medication safety
deprescribing
patient-centered care
older adults
url https://www.tandfonline.com/doi/10.1080/28355245.2025.2476133
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