Managing medication in very old age: A qualitative study among Faroese nonagenarians.

Background: Currently, people generally live longer, and consequently, the number of older people experiencing periods of multimorbidity and the need for medication will increase. Managing multiple medications can be a complex and challenging task, especially for older people who may experience a decline in their cognitive and physical abilities. The aim of this study was to gather knowledge on how home-dwelling people who are 90 years or older manage their daily medication, what strategies they use, and what challenges they experience regarding medication. This knowledge is necessary for providing support and care for the oldest old regarding their medication management in daily living.

Method: Semi-structured interviews were conducted with 10 men and women aged 91-97 years who were part of the Faroese Nonagenarian Study conducted in 2021. The analysis was conducted by using thematic analysis as suggested by Braun and Clarke.

Results: We identified three important themes for understanding how the oldest-old citizens manage medication and the challenges and worries that they sometimes experience. These themes were managing medication in daily living, challenges regarding medication management, and worries among the participating older people and their relatives. The majority of the participants received automated dose dispensing (ADD) services, which they considered a great help. In addition, they developed personal strategies to manage their medication. However, the changing colour and shape of tablets caused concern among the participants, and concern about side effects were not always taken seriously by their general practitioners.

Conclusion: In addition to personal strategies, ADD services helped the participants manage medications in daily living. However, user involvement and regular counselling with their doctors appeared to be insufficient and, in some cases, absent. This study points to the necessity of strengthening user involvement by providing sufficient and regular counselling about medication between healthcare providers and people of very old age.