Pilot program targets helping our elders manage medications

July 26, 2022

There is a pilot program being led by Cedars-Sinai pharmacists that is teaching high school students how to ensure their parents and grandparents are taking their medications correctly.

When Jason Lozada, 19, would open the medicine chest in his family’s shared bathroom, he would be concerned about the number of prescription bottles for his father, Vicente Lozada, 54, lining the shelves.

“I’d see a lot of medications and wonder, ‘What type of medications is he taking, and is he taking it right?’” Jason said.

Jason worried because his father had been diagnosed with Type 2 diabetes and, despite taking pills to treat the disease, still had a hard time controlling his blood sugar levels. Vicente’s physician had told him last year that his blood sugar levels were so high he might need to start taking insulin.

Vicente’s situation prompted Jason to act. He joined a pilot program led by Cedars-Sinai pharmacists, who taught high school students in underserved communities how to develop and maintain an accurate medication list for an older family member. By empowering teens and getting them engaged in their relatives’ health, The Grandparents Project could help reduce preventable trips to the hospital among older adults on multiple drugs who don’t take them as prescribed.

“Since my son got involved in this project, now I’m taking my medications at the proper time—I’m taking them seriously—and that's why my A1C (blood sugar levels) went down,” Vicente said.

Prescription for Disaster

Before Jason joined The Grandparents Project, Vicente never sought the advice of a pharmacist regarding the prescriptions he takes to control his diabetes, reduce his cholesterol and lower his blood pressure. And he wasn’t always taking them the right way. “Every time I pick up my pills, they always ask me if I need an explanation, but I'm always in a rush,” Vicente said.

He’s not alone. Patients don’t take half of all medications as prescribed, which leads to 125,000 deaths each year, according to the Centers for Disease Control and Prevention. Older adults face additional hurdles. Many take multiple drugs for a variety of issues that develop with age, making it hard to keep everything straight. Patients often don’t realize they’ve been taking their prescriptions wrong until they land in the hospital.

A desire to help these patients avoid a health emergency drove pharmacy leaders at Cedars-Sinai to launch The Grandparents Project. “We have a number of successful programs at Cedars-Sinai Medical Center in which pharmacists screen patient medication lists for errors and help improve patient safety,” said Chief Pharmacy Officer Rita Shane, PharmD. “But we only treat patients inside the hospital and wanted to extend our safety efforts to individuals in our community outside of our four walls.”

Empowering the Younger Generation

Shane and clinical pharmacist Thanh Tu, PharmD, who leads the project, needed a bridge to adults in the community and realized high school students could be the key.

Tu worked with the Cedars-Sinai Youth Employment and Development program to recruit 30 students from Fairfax High School. With the help of fellow pharmacists and intern pharmacists, she trained the teens to take a medication history from their older loved ones.

The students used the skills they learned to create an accurate medication list that includes the name of each drug their relative is taking, along with the dose, form (pill, liquid, injection) and frequency. Then they verified the medication information their loved ones provided with at least one other source, such as a prescription bottle.

The students also learned how to use trustworthy online resources to answer basic questions their relatives might have about their medications, such as common side effects. The students could consult Tu, the program’s on-call pharmacist, if they needed help with any complex or urgent medication questions. The teens even practiced taking medication histories with a pharmacy team member before sitting down with their parent or grandparent to collect their medication history.

The project held special meaning for Tu, a first-generation immigrant, who since junior high school had helped her mother navigate the healthcare system.

“My mother would ask me many questions about her own medications and the instructions she received from doctors and pharmacists. With this project, I want to teach high school students how to triage those types of questions to help their own family members,” said Tu, who serves as the pharmacy enterprise program coordinator at Cedars-Sinai.

At the beginning of the program, only seven out of 30 adults who participated had an accurate medications list. After three months, all 30 students had learned how to take a medication history, and 27 adults had maintained a complete and accurate medication list on their own. Tu and her fellow pharmacists reviewed each list to ensure participants were taking medications safely and did not have any dangerous drug interactions.

Tu finds the results encouraging and hopes to expand The Grandparents Project and reach more students in underserved communities. Though she had been concerned that the teens might find the program too difficult or boring, Tu was impressed by how engaged and invested Jason and the other students were in their loved ones’ health.

“This really broadened my knowledge about pharmacists and what they do,” Jason said. “It maybe even interested me in becoming a pharmacist.”

Cedars Sinai release