Visual impairment hampers elderly patients’ self-management

By Caroline Price

Elderly patients with visual impairment need extra support to help them manage their medications, report UK researchers.

Their study found that most visually impaired patients had difficulty reading medication information, while a quarter had difficulty distinguishing different tablets, particularly by different colors.

As a result, visually impaired patients were nearly three times as likely as control patients without visual impairment to need help managing their medications, which they received mainly from relatives and friends.

Margaret Cupples (Queen's University Belfast) and team suggest healthcare professionals should ask patients about their vision and check that they have enough support with taking their medications. Writing in the British Journal of General Practice, they also call for practical solutions, such as labeling in large print, different shapes of containers, "talking labels," "penfriends," syringe-filling aids, and pillboxes containing daily packs of medications.

The researchers studied a total of 314 patients (aged 65 years or older) living within the community, 156 with visual impairment (best-corrected visual acuity from 6/18 to 3/60) and 158 closely matched control patients without visual impairment (best-corrected visual acuity of 6/9 or better).

Around half of patients in each group reported perfect adherence to their two or more prescribed medications, which included cardiovascular, antidiabetic, psychotropic, analgesic, and/or gastroprotective drugs. Prescribing data supported these high levels of adherence in both groups, Cupples and team note.

However, almost all (97%) of the visually impaired group had difficulty reading medication labels, despite most using optical aids, compared with just seven (4%) of the control group. And 38 (24%) of the visually impaired individuals had difficulty distinguishing medications, compared with none of the controls.

In line with these findings, 29% of visually impaired patients reported having help to manage their medication (19% from a relative or friend and 10% from the pharmacist in the form of a compliance aid), compared with 13% of the control group (10% relative/friend and 3% pharmacist), representing a 2.8-fold higher relative need for support.

Interestingly, a large proportion of both groups had problems opening medications or blister packs.

Noting that patients mainly turned to social and family networks for help managing their medications, the authors say that sources of such informal support are likely to decline as society ages and the prevalence of visual impairment rises.

"Greater efforts should be made to engage with patients to determine cost-effective ways of minimising problems due to variation in generic preparations and of designing more accessible packaging," they add.

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