Do They Know What They Are Taking? Evaluating Medication Literacy and Self-Management Among Geriatric Patients With Polypharmacy Background: The burden of chronic disease and expanded pharmacologic treatment options result in polypharmacy in older adults. Complex medication regimens and limited medication understanding contribute to errors and decreased adherence. Limited data exist on how geriatric patients manage medications in outpatient settings and whether self-assessed knowledge reflects actual understanding. Objectives: To characterize medication tracking strategies, evaluate understanding of medication purpose, identify self-management barriers, and inform future clinic-based interventions among geriatric patients with polypharmacy. Methods: A mixed-methods assessment was conducted in a Rhode Island outpatient internal medicine clinic. Adults aged ≥65 years prescribed five or more medications were recruited via convenience sampling. A structured interview assessed tracking strategies, self-reported confidence, provider communication, and medication knowledge by asking participants to identify each medication's purpose given their medication list, verified with the electronic health record. Data were analyzed using descriptive statistics and thematic analysis. Results: Participants (n=36) had the average age of 79 years (range 65-91). Pill organizers (61.1%) were the most common tracking strategy, followed by taking medications directly from pharmacy bottles (30.6%), and written lists (16.7%). Most participants (83.3%) rated their confidence as 5 out of 5. Despite high confidence level and 86.1% reporting no barriers to management, less than half (48.8%) correctly identified the medication’s purpose. Significant EHR discrepancies were observed with patients taking far fewer medications than in their chart, and active medications listed despite allergies or no prior use, suggesting inconsistent medication reconciliation at routine check-ins. Conclusions: A significant gap exists between self-reported confidence and objective medication knowledge in geriatric patients with polypharmacy. While most patients use established tracking systems, understanding of medication purpose was limited. Discrepancies between patient-reported medications and EHR records highlight additional concerns regarding medication reconciliation in outpatient settings. Findings suggest opportunities for targeted interventions to promote safer medication self-management in this population. Eunsol Moon (author) Author Thomas Bledsoe, MD (mentor), Therese Zink, MD (mentor) Author polypharmacy medication literacy geriatric patients medication self-management health literacy outpatient primary care medication reconciliation older adults quality improvement medication adherence medication knowledge patient safety primary care Brown Internal Medicine medication tracking EHR discrepancy All rights reserved In Copyright text_resources instructional posters riu Providence, Rhode Island Brown University Library 2026 2026-04-29 1 document born digital 10.26300/3hz1-wz93