Background:

Medication adherence in chronic disease is frequently suboptimal, contributing to poorer outcomes and higher healthcare use. Home health care patients often live with multimorbidity and polypharmacy, which can further complicate self-management and adherence. In parallel, medication stability and safety can be affected by variable home storage conditions compared with controlled pharmacy environments, yet real-world home storage/organization practices are rarely assessed in a structured way.

Research questions:

What are the common medication storage locations and organization patterns in home health care patients with polypharmacy?
What medication safety risks are visible in home environments?

Method:

Cross-sectional qualitative study using convenience sampling of 15-20 patients (age ≥65 years, ≥2 chronic conditions, ≥5 daily medications) receiving home health care services who agree to participate. During routine home visits, one researcher will collect demographic/clinical data (including Turkish-validated Modified Morisky adherence scale), take 1-2 photographs per medication storage location with patient consent. Photographs will be analyzed by two independent researchers using thematic categorization examining storage locations (room type, specific container/furniture, visibility, co-storage items), organizational practices (original packaging vs. removed, labeling, separation by day/time, pill organizer use), and visible risks (expired medications, inappropriate storage conditions, hazardous items). Inter-rater reliability will be calculated, with disagreements resolved through discussion.

Results:

This is a study proposal; following ethical approval, data collection will commence, and preliminary findings will be presented at the conference.

Conclusions:

A photo-assisted descriptive approach may provide a feasible way to characterize real-world medication storage/organization and contextualize adherence challenges in home health care, informing future interventions and multicenter collaboration.

Points for discussion:

What is the best way to standardize home medication photos across sites while maximizing comparability?

For a future analytic phase, should we prioritize developing a quantitative photo-based risk assessment or expand qualitative methods first?

Which minimum descriptive variables are essential?