Patient Perspectives on Medicines and Their Impact on Frailty and Falls: A Qualitative Study

Introduction

Frailty and falls are significant concerns for older adults, leading to reduced independence and increased healthcare needs. Medicines, particularly polypharmacy, can contribute to frailty and falls yet patient awareness of these risks remains unclear. Patient engagement is essential to inform strategies that improve knowledge and reduce the risk of medicines related harm.

Methods

Participants were identified by the local NHS patient engagement team and invited to participate in focus groups. Semi-structured interview templates were designed by the study team. Sessions were recorded, transcribed verbatim, and anonymised. Data were analysed inductively using Braun and Clarke’s six-step thematic analysis, coded by two team members, with independent verification. Initial themes were developed after three focus groups, with data saturation tested by one further group.

Results

Four focus groups were held with a total of 12 participants. Data saturation occurred at this point and recruitment stopped. Thematic analysis identified four key themes:

• Variable knowledge and experience of medicines – participants highlighted a link between side effects of medicines and frailty and falls, concerns around lack of monitoring, follow up and regular medication review.  Patient quote “I do feel frailer as a result of the combination of various medications”
• Inconsistent understanding of frailty – variation on how participants described frailty but agreement that frailty affects quality of life
• Awareness of falls – common concerns that medication can cause falls and more education and preventative measures were needed
• Lack of clarity and quality of NHS services – feedback about lack of consistency in accessing NHS services and information; common agreement that posters or patient information leaflets are an acceptable way to share information

Conclusion

There is a lack of information available to patients on medication, frailty and falls.  Access to medication reviews could be improved. Further work is required to develop patient-approved resources and strategies to improve services.