Medication Literacy in Hospitalized Older Adults: Concept Development

Abstract

Background: Medication literacy encompasses the cognitive and social skills necessary for individuals to obtain, comprehend, communicate, calculate, and process medication-related information necessary to make informed decisions. Personal and contextual factors are widely recognized to influence the way that individuals acquire and maintain medication literacy skills. Despite a growing number of studies on medication literacy, current definitions remain general, lacking consideration for the specificities of older adults and hospitalization. Objective: The project was conducted to identify, compare, and summarize the attributes, antecedents, and consequences of medication literacy in hospitalized older adults and to propose a refined definition. Methods: A three-phase hybrid model of concept development was performed that included a literature review and focus groups with hospital nurses. In the final analytic phase, findings from the literature and focus groups were compared, and a refined definition of the concept was elaborated. Key Results: From the synthesis of 24 publications and the narrative data of 14 hospital nurses, 19 themes were described: 4 related to attributes, 8 to antecedents, and 7 to consequences. Medication literacy of hospitalized older adults has been further defined as the degree to which older adults and/or their natural caregivers can develop and maintain multidimensional skills, namely functional, interactive, and critical medication literacy skills. Adjustment of these skills is characterized by a dynamic and potentially complex process. In practice, optimal medication literacy might be achieved through control of and involvement in the medication regimen and the decisions related to it, and/or by using practical means to facilitate medication self-management (e.g., using lists, notes, reminders). Conclusions: The proposed refined definition might enhance professionals' common understanding of the concept and its application in practice, policy, and research. Managing a medication regimen is a complex activity that requires a high level of integration and coordination of cognitive and social skills. [ HLRP: Health Literacy Research and Practice . 2022;6(2):e70–e83. ] Plain Language Summary: Based on the literature on medication literacy and the experiences of nurses working in hospitals, this article defines medication literacy in hospitalized older adults. This definition will help professionals to better understand challenges related to medication literacy in older patients and to propose adequate support (i.e., provide education, simplify medication prescriptions, propose practical aids such as a pillbox).

Conceptualization and content validation of the MEDication literacy assessment of geriatric patients and informal caregivers (MED-fLAG)

“…development study, including a literature review and focus groups with hospital nurses [8]. During workshops, a multidisciplinary research team, including nurses, a geriatrician, a pharmacist and a citizen co-researcher (i.e., patient partner) were invited to reflect on what they would consider essential skills in the functional, interactive and critical domains, contributing to the clarification of subdomains.…”

“…Medication literacy was recently defined in a concept development study, as the degree to which older adults and/or informal caregivers can develop and maintain functional, interactive and critical skills [8]. These skills involve, for instance, the abilities to understand, prepare and self-administer medication (functional domain), to actively interact with healthcare providers, to express concerns and take part in decisions (interactive domain), and to seek reliable medication-related information, exert control over medication management and act appropriately in case of problems (critical domain).…”

Association between social support and medication literacy in older adults with hypertension

“…The degradation of physiological and cognitive functions caused by aging, such as the reduction of vision, attention and memory and the decline of executive ability and judgment, all interfere with safe medication practice in older adults ( 11 – 13 ). On the other hand, the lack of pharmaceutical guidance services and the complexity of medication-related information (prescriptions and drug instructions) also increase the difficulty of obtaining, comprehending, communicating, calculating and processing medication-related information ( 14 – 16 ). Therefore, the problem of safe medication use in older adult patients with hypertension is worthy of attention.…”