Medication Management Models for Rural Healthy Aging

Medication is an important part of staying healthy as people get older. It helps manage health problems, improves quality of life, and allows older adults to stay independent. Medication management means taking medicine safely and correctly. This helps older adults avoid problems with medications and stay safe when using both prescription and over-the-counter drugs, especially since older adults often take more medications. As people age, their bodies change, which can affect how medicines work. A Centers for Disease Control and Prevention fact sheet describes examples of medication categories that can be linked to injuries as people age and tips for medication management, including a MyMedications Action Plan.

For older adults in rural areas, managing medications is even more important because they may live farther from doctors and have more health problems. Some states have areas called pharmacy deserts. Pharmacy deserts are defined as locations where people must drive more than 10 miles to a pharmacy. This makes it more difficult for them to get the healthcare they need.

The following program models focus on using pharmacies to help older adults in rural areas. These programs improve medication use, help manage long-term health conditions, support at-home medication management, and create age-friendly pharmacies to better serve older adults.

Pharmacy-based Interventions to Improve Medication Adherence. Pharmacies can create special programs to help people take their medicine correctly. They do this by learning what makes it difficult for people to take their medicine and then providing support to address those barriers, which has shown to be helpful for older adults. Experts recommend that public health workers and local health departments encourage and support pharmacies in offering these programs.

Pharmacists have always played an important role in keeping communities healthy, and their services have grown over time. The Rural Pharmacy and Prescription Drugs topic guide provides more information about rural pharmacies and the challenges they face.

Rural areas may have fewer pharmacies, but smaller regional pharmacy chains can offer benefits over big national ones. These smaller pharmacies often give pharmacists more time to help patients, making them a more important part of their healthcare team.

Managing Medications for Chronic Disease. Rural areas have higher rates of chronic diseases, and many people have more than one health condition, leading to higher death rates. The Rural Health Chronic Disease Management Toolkit provides examples of programs that help people in rural areas manage their medications for chronic diseases.

Managing Medications at Home. Home visits by healthcare workers can help older adults keep track of their medications. These visits also support caregivers by making medication management easier while helping older adults stay independent. In rural areas, caregivers often work as a team to help older adults take their medicine correctly. There is emerging evidence that technology-based interventions can help older adults manage medications in home-care settings.

Using Telehealth and Telepharmacy Services. Telehealth and telepharmacy allow patients to talk to healthcare professionals from their own homes and communities, reducing the need to travel. This helps people in rural areas get the care they need more easily.

Age-Friendly Pharmacies. The Age-Friendly Health Systems Framework helps pharmacies better support older adults with medication management. The American Society of Consultant Pharmacists is applying this approach in 250 long-term care pharmacies. By working together, healthcare professionals can use the Age-Friendly Health Systems 4Ms framework to improve medication management. One example is pharmacists helping doctors stop unnecessary or harmful medications.

Pharmacy-Based Convenient Care in Rural Areas. Pharmacy-based convenient care settings provide important healthcare services for people in rural areas who have limited access to medical care. Different program models help guide how these services are set up and can serve as examples for other rural communities.

Medication Synchronization Programs. Many pharmacies offer this service to coordinate prescription refills, so all medications are ready for pickup on the same day each month. This reduces multiple trips to the pharmacy and makes managing medications easier.
Retail Pharmacy Services in Rural Areas. Large companies have expanded healthcare services in rural communities to improve access. In some locations, home delivery is also available. Partnerships have also been formed to make medication therapy management available.
- A team from Case Western University is working to make healthcare age-friendly for older adults with support from IHI. These programs will help providers incorporate age-friendly care into their services and track the results.

Resources to Learn More

4Ms in Age-Friendly Care Orientation: Application of the 4Ms in Age-Friendly Care within Convenient Care Settings
Training
Training course to learn how to provide age-friendly care, specifically in pharmacy-based convenient care settings.
Organization(s): Age-Friendly Health Systems

Improving Medication Adherence in Older Adults
Website
Explains why older adults often struggle to take medications as prescribed and outlines practical strategies that healthcare providers, family members, and caregivers can use to support better medication adherence.
Organization(s): Georgetown University School of Nursing

Medicines Risk Fact Sheet
Website
Shares fact sheets and other medical list planning documents to help older adults to identify medications that put them at risk of falls or motor vehicle crash, potential side effects, and questions they can ask their doctor.
Organization(s): Centers for Disease Control and Prevention

Pharmacist-Provided Medication Therapy Management in Medicaid
Document
Discusses strategies state agencies can implement to support pharmacist-provided medication therapy management for Medicaid patients with chronic conditions.
Organization(s): Centers for Disease Control and Prevention
Date: 5/2021