An Educational Intervention to Promote Communication between Older Adults and Health Care Providers

Background and Purpose: Older adults are at greater risk for physical and psychological problems as they age, which makes it increasingly important for them to have effective dialogue with their health care professionals about their health needs. Older adults especially need to understand the implications of medication use, along with an appreciation of the dangers inherent in combining alcohol with prescriptions and/or over the counter medications (Immonen, Valvanne, & Pitkäl, 2013; National Institute on Aging, 2018). Although national studies have found that about 40 percent of adults ages 65 and older drink alcohol, many do not understand the dangers arising from combining alcohol with medications (National Institute for Alcohol and Alcohol Abuse, 2008).

Methods: An educational intervention was developed with a team of expert physicians, nurses, pharmacists and social workers who work in gerontology aimed at improving communication. The educational intervention targeted three core areas: (1) Education about alcohol abuse and misuse; (2) Education about concomitant alcohol and medication misuse; and (3) How older adults can talk with their physician, pharmacists and health care professionals about safety issues. A randomized controlled trial (RCT) was conducted to assess whether the intervention improved older adults’ ease in communicating with their health care providers, as well as their knowledge of the concomitant use of alcohol and prescription and OTC medications.

Results: The RCT involved 115 participants who attended senior centers throughout New York City, with 55 participants in the intervention group and 60 participants in the control group. The intervention group received two educational sessions on communicating with their health care providers, while the control group received the same sessions after the research was completed. Results were analyzed using MANCOVA and a series of multiple linear regression models. Using the MANCOVA test, a statistically significant group difference was found in scores on communication with their physician, the importance of communicating with their physician, and knowledge about alcohol and medication use (Wilks’ Lamda=.808, F(3,76)=6.039, p=.001<.05). Regression analysis also confirmed that there was a group difference in knowledge about alcohol and medication, after controlling for the pretest, gender, age, education, living status, race, marital status, and health status, with those in the intervention group exhibiting an increase in their scores of approximately 1.00, which represented a substantial increase given the average score of 6.5. There was also a difference in scores on communication with their physician by group when controlling for the pretest, with the intervention group displaying a larger increase in scores.

Conclusions and Implications: The findings indicate that participants in the intervention group produced a significant difference in scores on communication with health care professionals and knowledge about the implications of combining alcohol with prescription drugs as compared to those in the control group. Although the findings are limited to a group of participants at senior centers in NYC, it appears that the educational intervention made a positive impact in improving communication with health care providers and increasing knowledge on alcohol and medication use for older adults taking part in the research.