3583 Impact of Health Literacy and Risk perception on Over-the-Counter Medication Misuse

Abstract

OBJECTIVES/SPECIFIC AIMS: This study aims to describe factors impacting older adult OTC selection and use so they can be targeted with a community pharmacy intervention to improve older adult medication safety. The primary outcome is the characterization of the relationship between health literacy, risk perception, and OTC misuse. These results will directly inform the refinement of the community pharmacy intervention such that it is tailored more precisely to the older adult patient population. METHODS/STUDY POPULATION: This cross-sectional study administers face-to-face surveys to 72 older adults (age 65+) at three locations of a mass-merchandise chain pharmacy. This study is one component of a larger study to develop and implement a community pharmacy intervention to improve OTC safety for older adults. The Protection Motivation Theory (PMT) provides a framework for evaluating the interplay of threat and coping appraisals in the assessment of perceived risk severity and OTC misuse. Health literacy, known to contribute to coping appraisals, is measured with the Newest Vital Sign survey. The TRI-RISK model, originally used to measure risk perception of disease, was adapted and subject to rigorous cognitive interviewing and testing with 8 older adults. This adapted survey is used to measure older adult risk perception of adverse drug events. Walking interviews with older adult participants are conducted in a community pharmacy. In these interviews, participants verbalize their process of selection and use of an OTC to treat a pain, cough/cold, or sleep issue. Additional patient factors such as age, race, gender, education level, and co-morbidities are collected in a survey. Structural equation modeling is used for data analysis. RESULTS/ANTICIPATED RESULTS: It is hypothesized that poor health literacy leads to lower risk perception, which will result in increased instances of potential adverse drug events. Data collection will be complete by Spring 2019 and preliminary results will be presented. DISCUSSION/SIGNIFICANCE OF IMPACT: Few interventions have attempted to decrease misuse of high-risk OTC medications in older adults, and not one has addressed system barriers. Compared to efforts to improve prescription medication safety, efforts to decrease OTC medication misuse in community-dwelling older adults have been practically ignored. This is the first study to characterize and operationalize health literacy and risk perception of adverse drug events in the development of a system-level intervention to address OTC safety for older adults. The population aged 65 and older is expected to increase by 38.5 million from the year 2020 to 2050. Interventions tailored to target the older adult patient population are expected to have greater efficacy in improving older adult medication safety and in alleviating the significant corresponding strain on the US healthcare system.