Barriers to Effective Older Adult Medication Self Management Behaviors in Conjunction with a Neuropathic Pain Treatment Plan

Burge, Donna M.

Saturday, 29 October 2011: 3:55 PM

Donna M. Burge, PhD, BC-APRN, CNS
Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, MD

Learning Objective 1: Describe the most commonly identified reasons for poor medication self management behaviors in older adults with chronic neuropathic pain.

Learning Objective 2: Discuss ways an advanced practice nurse can improve medication self management behaviors in older adults with chronic neuropathic pain.

Purposes were to examine effects of medication side effects, cognitive impairment, depression, and medication affordability on older adult medication self management behaviors in conjunction with a neuropathic pain treatment plan, identify additional variables causing issues, and identify possible nursing intervention categories to improve patient medication self management behaviors. A correlational study design was used. Descriptive information was collected from participant records. Cognitive ability and depression were measured using the Mini Mental Status Exam (MMSE) and the Center for Epidemiologic Studies Depression Scale (CES-D) respectively. Descriptive statistics were used to identify means and standard deviations. Correlation statistics were utilized to identify statistically significant relationships between variables. Study size was 95 participants. Participant mean age was 72. The average MMSE score was 26.4 and average CES-D score was 13.3. Thirty-two participants reported experiencing medication side effects. Average percentage of income spent on medications was 11%. Average number of daily medications was 8. Average reported pain score was 6. Twenty-three participants (24.2%) were found to not follow the treatment plan. No relationship was found between self management behaviors and cognitive impairment, depression, or medication affordability. In the regression model, medication side effects was the only significant predictor of demonstration of poor medication self management behaviors (p=.04). Failure to understand the treatment plan was an unanticipated finding (n=5, 16.7%). Medication side effects were found to be a significant predictor of poor patient medication self management behaviors but there was no effect by cognitive impairment, depression, or medication affordability. Misunderstood treatment plans may lead to issues. Adding cognitive and behavioral nursing interventions to improve understanding of the treatment plan and minimize side effects should improve these behaviors.

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