Not what the doctors order
A Northeastern University faculty researcher said the elderly often fail to take their medications as prescribed, creating quality-of-life issues, especially for older people with multiple chronic diseases.
A study by Associate Professor of Pharmacy Practice Kathy Bungay revealed how those diagnosed with depression and other chronic conditions, like diabetes and hypertension, manage a complex list of medications and dosages between visits to the doctor.
The results showed patterns of behavior that may help physicians, pharmacists and other caregivers understand how best to help older people accept new medications and maintain their existing medication regimen at home.
“I don’t think we’ve really asked people what they do at home,” said Bungay. “In the real world, it’s shocking; there’s a whole host of medication-taking behaviors that are different than what their physician prescribes. My goal was to hear, in their own words, what they’re doing.”
For the project — funded by an $890,000 National Institutes of Mental Health grant — Bungay interviewed 49 people age 60 to 87 in the Boston area to explore their motivations and methods for taking medications, especially antidepressants. Previous studies have shown that the elderly are averse to taking antidepressant medications.
Her interviews uncovered one explanation for this finding — they use antidepressants to relieve symptoms of depression, but are reluctant to admit that they suffer from the actual condition of depression.
The findings suggest that health-care providers may need to change how they communicate the need for antidepressants. “If they say ‘You know Mabel, you’re depressed. I want you to take this drug,’ that might not do it,” Bungay said.
She plans to continue the research by testing her findings in different populations. Ultimately, she hopes to expand it to all adults managing mental health problems and multiple chronic diseases. The research is particularly relevant today, she said, because people are living longer, but spending less time with their physicians.
Bungay, who came to Northeastern last year from Tufts Medical Center, is among just 20 to 30 pharmacy researchers in the nation chosen to serve as the principal investigator for a major National Institutes of Health grant.
