Improving Medication Understanding and Adherence Using Principles of Memory and Metacognition

Abstract

More than half of older adults regularly take multiple medications. Rates of medication non-adherence are high, which undermines both patients’ health and the economy. Memory and metacognitive factors (such as misplaced confidence) help explain why patients across the lifespan may not understand or follow prescribed regimens. These factors include difficulties in remembering confusing information; patients’ and practitioners’ potential overconfidence in memory; and misunderstandings about memory. Patients, practitioners, and the public can use these principles to improve memory, enhance understanding, and promote metacognitive accuracy with respect to complex medication information, which may increase the likelihood of adherence.

Medication Knowledge and Adherence in Type 2 Diabetes Mellitus Patients in Brunei Darussalam: A Pioneer Study in Brunei Darussalam

“…In this study, non-adherence was observed in a majority of the participants (74, 62.71) with forgetfulness being the main culprit (64, 86.49%). As a lot of the patients were on polypharmacy, receiving excessive information on their medications may result in difficulties to retain vital information, thus leading to forgetfulness [ 31 ]. Medication adherence is only significantly correlated with race ( p = 0.011, r = −0.233).…”

Cholinesterase inhibitors for the treatment of dementia: real-life data in Hungary

“…More than half of the people over the age of 65 should take five or more medications regularly for chronic diseases and more than half of these patients had complication to follow the recommendation of their physicians, leading to serious healthcare and economic consequences [ 6 ]. Symptoms of dementia make it even more difficult to take antidementia drugs appropriately.…”

Knowing what others know: Younger and older adults’ perspective-taking and memory for medication information.

“…In the current study, a short task reduced or eliminated the extent to which younger and older adult participants overestimated their own and some others' performance. Further research is needed to determine how to implement cognitive principles to enhance learning and perspective-taking when people encounter large amounts of (potentially confusing) medical information, such as at a doctor's office or when reading medication dosage instructions (see Hargis & Castel, 2018a, for a review). Perhaps incorporating established techniques to improve memory and metacognitive accuracy into medical communication (e.g., testing; Larsen, Butler, Lawson, & Roediger, 2013;Roediger & Karpicke, 2006; making important information salient; Castel, 2008;Hargis & Castel, 2018a;Hargis, Siegel, & Castel, 2019;Middlebrooks, McGillivray, Murayama, & Castel, 2015; or understanding overconfidence; Koriat & Bjork, 2005;Metcalfe, 1998) can lead to less confusion, better remembering, and improved health outcomes.…”

“…Further research is needed to determine how to implement cognitive principles to enhance learning and perspective-taking when people encounter large amounts of (potentially confusing) medical information, such as at a doctor's office or when reading medication dosage instructions (see Hargis & Castel, 2018a, for a review). Perhaps incorporating established techniques to improve memory and metacognitive accuracy into medical communication (e.g., testing; Larsen, Butler, Lawson, & Roediger, 2013;Roediger & Karpicke, 2006; making important information salient; Castel, 2008;Hargis & Castel, 2018a;Hargis, Siegel, & Castel, 2019;Middlebrooks, McGillivray, Murayama, & Castel, 2015; or understanding overconfidence; Koriat & Bjork, 2005;Metcalfe, 1998) can lead to less confusion, better remembering, and improved health outcomes. In summary, the present work suggests that younger and older adults' perspective-taking can be improved after task experience, a finding which has implications for communicating and learning health-related information across the lifespan.…”

“…Future work can incorporate repeated judgments after each study-test cycle to assess how learning about one’s own and others’ memory abilities may change across lists within a task, and whether this learning may differ with age. Additional work may investigate the role of older adults’ stereotype threat and anxiety (e.g., Geraci & Miller, 2013; see also Hargis & Castel, 2018a) on memory for medical information, and whether these effects may be mediated by metacognition. Future work can also assess whether younger and older adults differ in how accurate they think their judgments were in this type of memory task (Tullis & Fraundorf, 2017) to investigate confidence in one’s perspective-taking and, potentially, to improve participants’ ability to take others’ perspectives when learning and communicating important information.…”