One-Year Follow-Up of Medication Management Capacity in Highly Functioning Older Adults

Abstract

Forty-seven (86%) of the eligible participants completed the 12-month follow-up assessment; three were transferred to skilled nursing facilities. The mean age at study entry was 84.2+/-5.1 years; 72% of the participants were women, and 68% were college educated. At 12 months there was a decline in the Mini-Mental State Examination (MMSE) score (p = .029), an increase in the timed "Up and Go" test (p = .023), and a decline in the DRUGS score (p .029). Nine (18%) of the participants resided in assisted- versus independent-living situations compared with three participants (5%) at study entry (p = .031). Both 12-month DRUGS score and 12-month self-reported medication management capacity were associated with 12-month MMSE (p = .0001 and p = .019, respectively). Baseline DRUGS score was associated with 12-month MMSE and Geriatric Depression Scale scores (p = .0002 and p = .002, respectively). Both baseline DRUGS score and self-reported medication management capacity were also associated with residence in assisted-living communities at 6 months (p = .029 and p = .040, respectively). MMSE was not associated with any of the clinical outcomes.

Voluminous gastric fibrosarcoma in a 75-year-old patient

“…cognitive function, IADL scores), or this information was not provided [40-45,47,50-52]. In other cases, the rater was blinded to some, but usually not all, patient data [39,46,48,49,56]. Most studies did not adequately describe reasons for patient exclusion or their characteristics relative to the study subjects [40-43,45-49,51], or whether study subjects were currently managing their own medications [42-44,46-51], making generalisation of findings difficult and introducing potential spectrum bias [13,18,57].…”

Acceptability and Face Validity of a Geriatric Self-Medication Assessment Tool

“…23 Evidence is also available that the ability to recall one's own medication regimen is associated with the Mini Mental State Examination (MMSE) score and that a decline may predict the need for future assistance with medication self-management, as well as other aspects of daily living. 9,10,24 As shown with the BMQ tool, recall screening can be highly sensitive to sporadic noncompliance. 11 The issue of how to phrase recall questions was addressed by many interviewees in the present study.…”

“…The Drug Regimen Unassisted Grading Scale (DRUGS) incorporated a stepwise progression of 4 tasks: identification, access, dosage, and timing. 9,10 This scale allows the assessor to calculate a score that has been found to be useful in identifying early deficits that can increase risk in medication self-management. 10 However, the DRUGS was evaluated in only a small cohort of well-educated, highly functioning older adults, and the power of the study was insufficient to detect differences in clinical outcomes.…”

“…9,10 This scale allows the assessor to calculate a score that has been found to be useful in identifying early deficits that can increase risk in medication self-management. 10 However, the DRUGS was evaluated in only a small cohort of well-educated, highly functioning older adults, and the power of the study was insufficient to detect differences in clinical outcomes. The Brief Medication Questionnaire (BMQ) was designed as a self-report tool for screening medication adherence and identifying barriers to adherence; upon completion of the questionnaire, the patient's rating on an Adherence Risk Scale can be determined.…”

Editorial: Hot Topics in Geriatrics

“…Polypharmacy remains a major problem in older persons (148)(149)(150)(151)(152). Its effects are compounded by the use of a variety of herbal medicines, many of which have no efficacy (153)(154)(155).…”