POLICY AND PRACTICE REVIEWS article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1453485
Enhancing primary care for older adults: the Safety, Efficacy, and Adherence team-based care model for reducing adverse medication outcomes
Provisionally accepted- 1Wright Institute, Berkeley, United States
- 2John Muir Health, Walnut Creek, California, United States
- 3Contra Costa Health Services, Martinez, California, United States
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Abstract Introduction: Older adults face significant health risks owing to gaps in the management of polypharmacy and medication adherence, as well as the integration of physical and mental health needs. Current models do not fully address these challenges. This study introduced the Safety, Efficacy, and Adherence (SEA) model designed to enhance interdisciplinary collaboration, improve medication management, and integrate care for older adults. This model addresses the core drivers of poor health outcomes: (1) medication adherence challenges, (2) social determinants of health, (3) polypharmacy, (4) team-based care with family support for deprescribing, and (5) psychosocial factors related to aging. Methods: The SEA model was developed through a structured literature review focusing on medication safety, polypharmacy, behavioral health integration, home safety inspections and adherence. It draws on frameworks such as the Chronic Care Model, Interprofessional Collaborative Care for Older Adults, and Consolidated Framework for Implementation Research. This model fosters interdisciplinary collaboration by integrating pharmacists, primary care providers, mental health professionals, substance use treatment, and family support, and it is adaptable to diverse clinical settings. Results: The SEA model assessed short- and long-term outcomes. Potential short-term effects included improved medication adherence, enhanced team coordination, and reduced occurrence of adverse drug events. Long-term goals and possible effects included better chronic disease management, fewer hospitalizations, and improved quality of life for older adults. The model’s scalability allows for application across various healthcare settings, although further testing is required for validation. Conclusions: The SEA model provides a comprehensive framework for addressing the complex needs of older adults by focusing on medication SEA. Two vignettes, one clinical and one organizational, demonstrate the practical application of the model in patient care and implementation science. By improving interdisciplinary collaboration and addressing social and behavioral factors, in home safety for medications, this model aims to reduce polypharmacy and hospitalization. Based on existing evidence-based frameworks, this model would benefit from future studies to validate its effectiveness in diverse settings.
Keywords: Gerontology, Polypharmacy, geriatric primary care, Integrated behavioral health, Older adult care, Interdisciplinary care, Deprescribing, social determinants of health
Received: 23 Jun 2024; Accepted: 10 Jul 2025.
Copyright: © 2025 Changaris. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Michael C. Changaris, Wright Institute, Berkeley, United States
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