Review of Prescription and Other Medications and Supplements. Renée M. St. Louis, MPH

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1 Review of Prescription and Other Medications and Supplements Renée M. St. Louis, MPH Meeting the Challenges of Safe Transportation in an Aging Society Symposium September 14, 2016

2 Acknowledgements Emmy Betz, MD, MPH, Associate Professor, Department of Emergency Medicine at the University of Colorado School of Medicine collaborators that assisted in the development of this data collection instrument

3 Aging and driving Driving issues in the older adult population Driving issues are not due to age per se Medical conditions are more common in older people These conditions lead to declines in abilities that affect driving

4 Medical conditions Source: Eby, Molnar, & Kartje, 2009 Vision Cataracts Color vision deficits Glaucoma Monocular vision Macular degeneration Hearing loss Psychiatric Depression Cardiovascular Coronary heart disease Atrial fibrillation Congestive heart failure Abnormal blood pressure Cerebrovascular Transient ischemic attack Stroke Respiratory Asthma COPD Neurological Syncope Epilepsy/seizures Sleep apnea Multiple sclerosis Parkinson s disease Dementia Metabolic Diabetes Thyroid Musculoskeletal Arthritis

5 Medication use Medication use and polypharmacy (the use of multiple medications) is very high among older drivers: Over 90% of older drivers take prescription medications Over two-thirds of those taking any medication take multiple medications Individual differences in how medical conditions and medications affect driving skills Effects change based on other medications taken

6 Brown Bag Medication Review Participant brings all medications and supplements to their in-person visits and reviews them with research assistant Goal is to determine what medications participants are taking and how they are taking them More thorough and accurate than relying on medication information derived from medical record data

7 Brown Bag Medication Review Prescription medications Over-the-counter medications Vitamins Supplements Herbal medications Topicals, liquids, injectibles, and inhalants

8 Information gathered during review Generic name/ingredient Brand name Dose/unit of 1 st drug (e.g., 40 mg, 1 tablet, 3 drops, 1,000 units) Dose/unit of 2 nd drug, if applicable Frequency (e.g., daily, 2x per day, weekly, every 5 minutes) As needed? Route of ingestion Oral, nasal, ophthalmic, subcutaneous, intramuscular, etc.

9 Information gathered, cont. Prescribed by physician or other clinical practitioner Currently taking Taking as directed or suggested Yes/Partial/No Side effects specify if yes Method in which review was conducted Box/bottle/package visualized (preferred), list from pharmacy/provider, handwritten list, participant memory Notes section to document additional details

10

11 Common medications/supplements Low-dose aspirin (81mg) Vitamin D 3 Multivitamins Fish oil Nasal sprays Omeprazole (Prilosec) and various antacids Acetaminophen and other over-the-counter pain relievers Lisinopril and other blood pressure lowering drugs Statins for lowering cholesterol Number of medications/supplements varies widely by participant 0-34

12 Possible questions to consider Is there an association between self-regulation of driving and medication use? What types/classes of medications, if any, are associated with crashes and violations? How does the use of supplements and over-thecounter medication relate to health functioning? What psychosocial correlates are associated with the use of medication?

13 Questions? Renée M. St. Louis Project Coordinator

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