P07 - Teaching Nurse Practitioner Students About Polypharmacy Through A Lived Experience

Polypharmacy (typically defined as the concomitant use of 5 or more medications) affects 40-50% of older adults in the US and is associated with geriatric syndromes, a higher risk of medication non-adherence, and adverse drug events. Medication non-adherence is a common frustrating issue for clinicians who provide care for older adult patients. Simultaneously, patients often find medication regimens to be complicated and confusing. This may contribute to medication non-adherence, which may further lead to adverse drug events and negative health outcomes. The more medications a patient is taking, the higher the risk for non-adherence. Graduates of adult-gerontology primary care nurse practitioner (AGPCNP) programs must have an advanced understanding of barriers to and enablers of medication adherence to improve chronic care management and health outcomes for older adult patients (AACN Essentials VIII and IX). AGPCNP curricula must include learning activities that support student understanding and practice of patient-centered care that acknowledges culture, values, beliefs, socioeconomic means, and cognitive abilities (AGPCNP Independent Practice Competencies 3a, 3d, 3e, and 4). 38 AGPCNP students enrolled in an advanced health assessment course were given a one-month supply of five mock medications that are commonly prescribed for older adults. Students were instructed to follow directions on each of the bottles for approximately one month. A private messaging system was available for questions about medications or if refills were needed. At the conclusion of this month-long activity, a debriefing session was held, at which time students returned medication bottles. All returned bottles contained mock medications, but pill counts were not analyzed. Approximately 52.6% of students estimated adhering to the medication regimen 0-24% of the time, whereas 26.3% students reported an adherence rate of 25-50%. The most commonly cited barrier to adherence (55.3%) was “forgetfulness.” Pill boxes were ranked as the most effective adherence aid, but 57.9 % of students reported using no aids. Nearly all students (89.5%) reported that the exercise “very much” increased awareness of challenges patients face when managing medications, and 97% cited an increased awareness of ways to improve medication adherence. Students endorsed implementation of this simulation activity in future iterations of the course.