Older Adults’ Strategies for Obtaining Medication Refills in Hypothetical Scenarios in the Face of COVID-19 Risk

Vordenberg, Sarah E.; Zikmund-Fisher, Brian J.

Abstract Objective To identify whether older adults would avoid going to the pharmacy (e.g., by restricting medications or requesting delivery) due to the risk of COVID-19. Our secondary objectives were to determine which types of medications older adults may be more likely to restrict and to determine factors that influence these decisions. Design Cross-sectional survey experiment in which participants read 6 scenarios, each stating they had a three-day supply of a particular medication remaining. Setting and participants National web-based survey distributed to 1,457 U.S. adults 65 years and older by Dynata during March 25 – April 1, 2020. Outcome measures Participants reported whether they would go to a pharmacy, have a medication delivered, or restrict use of each medication. They reported their perceptions and experiences with COVID-19, health risk factors, preferences for more or less care (Medical Maximizer-Minimizer), medication attitudes (Beliefs about Medicines Questionnaire), health literacy, prescription insurance status, and demographics. Results Most participants (84%) were told to shelter in place, but only 12% reported attempting to obtain extra medications. Participants most often reported that they would go to the pharmacy to obtain each medication (range tramadol 48.9% to insulin 64.9%), except for zolpidem which they were most likely to restrict (45.4%). Participants who reported risk factors for COVID-19 (beyond age) were just as likely to go to the pharmacy as those without. In multinomial logistic regression analyses, women and the oldest participants were more likely to seek delivery of medications. Restricting medications was most common for 2 symptom-focused medications (tramadol and zolpidem), and both demographic factors (e.g., gender) and beliefs (e.g., medical maximizing-minimizing preferences) were associated with such decisions. Conclusion Many older adults intend to continue to go to the pharmacy to obtain their medications during a pandemic, even those who have health conditions that further increase their risk from COVID-19.