Self‐assessed medication risk factors as part of comprehensive health screening in home‐dwelling older adults

Kanninen, Jonna‐Carita; Puustinen, Juha; Airaksinen, Marja; Kautiainen, Hannu; Koivisto, Anna-Liisa; Hietasalo, Pauliina; Heikkilä, Anna‐Maija; Kunvik, Susanna; Toivo, Terhi; Dimitrow, Maarit; Bergman, Jussi; Holm, Anu

doi:10.1002/hsr2.1196

Cited by 3 publications

(6 citation statements)

References 32 publications

(45 reference statements)

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“…According to a recent population-based survey in Finland by the National Medicines Agency, only 20% of the respondents reported having an up-to-date medication list [ 46 ]. Similar results were obtained from a recent regional health screening study among 75-year-old home-dwelling residents ( n = 953), which used the LOTTA Checklist as an outcome indicator for medication-related risks [ 47 ]. Nearly half (43%) of the older medicine users missed an up-to-date medication list.…”

Section: Discussionsupporting

confidence: 77%

“…‘Bruising easily or getting nosebleeds easily’ and ‘Unusual dryness of the mouth’, were not listed in the DRP-RAT tool. However, those symptoms are quite common [ 47 ] and may significantly impair the quality of life and functional ability. The LOTTA Checklist was utilised as a part of a comprehensive health screening for 953 home-dwelling 75 year old residents in the PORI75 epidemiological study [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, those symptoms are quite common [ 47 ] and may significantly impair the quality of life and functional ability. The LOTTA Checklist was utilised as a part of a comprehensive health screening for 953 home-dwelling 75 year old residents in the PORI75 epidemiological study [ 47 ]. The participants frequently self-reported symptoms listed in the checklist, the most prevalent symptoms being constipation (21%), urinating problems (20%), unusual tiredness (17%), bruising easily or getting nosebleeds easily and unusual dryness of the mouth (both 16%).…”

Section: Discussionmentioning

confidence: 99%

“…The Medication Risk Checklist (LOTTA) can also be used in assessing the need for different social or healthcare services. This way of use has been piloted in a large epidemiological cohort study which utilised the checklist as a part of comprehensive health screening among older adults aged 75 years [ 47 ]. The study gathered information on medication-related risk factors among home-dwelling older adults to be used in future planning and implementing health services.…”

Section: Discussionmentioning

confidence: 99%

“…This way, the older adults could complete the list independently at home, and healthcare professionals would easily access information on potential medication risks. The checklist can also be used as an electronic indicator providing useful information for planning health services in the future [ 47 ]. Health and social care personnel in health centres can use the checklist to identify older risk patients, e.g.…”

Section: Discussionmentioning

confidence: 99%

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Medication risk checklist for older adults (LOTTA) – development and validation of a self-assessment tool

Dimitrow,

Saarenmaa,

Airaksinen

et al. 2023

Annals of Medicine

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Background Patient safety strategies highlight patients’ own active involvement in ensuring medication safety. A prerequisite for involving patients in their medication therapy is having tools that can assist them in ensuring safe medicine use. Older home-dwelling adults with multiple medications are at high risk for medication-related problems, yet only a few age-specific patient self-administered medication risk screening tools exist. This study aimed to develop, validate, and assess the feasibility of a self-administered medication risk checklist for home-dwelling older adults ≥65 years. Materials and methods The draft checklist was formed based on a validated practical nurse-administered Drug Related Problem Risk Assessment Tool supplemented with findings from two systematic literature reviews. The content validity of the draft checklist was determined by a three-round Delphi survey with a panel of 19 experts in geriatric care and pharmacotherapy. An agreement of ≥80% was required. A feasibility assessment (i.e. understandability of the items, fill-out time of the checklist) of the content-validated checklist was conducted among older adults ≥65 years ( n = 87) visiting community pharmacies ( n = 4). Data were analysed using qualitative content analysis. Results The final validated and feasibility-tested Medication Risk Checklist (LOTTA) for home-dwelling older adults consists of eight items screening the highest priority systemic risks (three items), potentially drug-induced symptoms (one item), adherence, and self-management problems (four items). The checklist proved feasible for self-administration, the mean fill-out time being 6.1 min. Conclusions A wide range of potential medication risks related to the medication use process can be identified by patient self-assessment. Screening tools such as LOTTA can enhance early detection of potential medication risks and risk communication between older adults and their healthcare providers. A wider and more integrated use of the checklist could be facilitated by making it electronically available as part of the patient information systems.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Medication risk checklist for older adults (LOTTA) – development and validation of a self-assessment tool

Dimitrow,

Saarenmaa,

Airaksinen

et al. 2023

Annals of Medicine

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Harmonizing the definition of medication reviews for their collaborative implementation and documentation in electronic patient records: A Delphi consensus study

Lias,

Lindholm,

Holmström

et al. 2024

Research in Social and Administrative Pharmacy

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Perceived Fatigability, Fatigue, and Mortality in Mid-to-Late Life in the Baltimore Longitudinal Study of Aging

MARINO,

CHEN,

DEAL

et al. 2023

Medicine &Amp; Science in Sports &Amp; Exercise

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Introduction/Purpose Fatigue is an established prognostic indicator of mortality risk. It remains unknown whether fatigability anchored to a physical task is a more sensitive prognostic indicator and whether sensitivity differs by prevalent chronic conditions. Methods 1,076 physically well-functioning participants aged ≥50 years in the Baltimore Longitudinal Study of Aging self-reported fatigue (unusual tiredness or low energy) and had perceived fatigability assessed after a standardized treadmill walk. All-cause mortality was ascertained by proxy contact and National Death Index linkage. Cox proportional hazards models estimated associations of perceived fatigability and fatigue with all-cause mortality, adjusting for demographic and clinical covariates. Interactions by chronic conditions were also examined. Results Each one-standard deviation higher in perceived fatigability, unusual tiredness, or low energy was associated with a higher relative hazard of all-cause mortality after covariate adjustment (fatigability: HR = 1.18, 95% CI: 1.03-1.36; unusual tiredness: HR = 1.25, 95% CI: 1.08-1.44; low energy: HR = 1.27, 95% CI: 1.10-1.46). Models had similar discrimination (p > 0.14 for all). Perceived fatigability was associated with mortality risk among participants free of arthritis or osteoarthritis who otherwise appeared healthy (no arthritis: HR = 1.45, 95% CI: 1.15-1.84; arthritis: HR = 1.09, 95% CI: 0.92-1.30; p-interaction = 0.031). Unusual tiredness was associated with mortality among those with a history of diabetes (no diabetes: HR = 1.16, 95% CI: 0.97-1.38; diabetes: HR = 1.65, 95% CI: 1.22-2.23; p-interaction = 0.045) or pulmonary disease (no pulmonary disease: HR = 1.22, 95% CI: 1.05-1.43; pulmonary disease: HR = 2.15, 95% CI: 1.15-4.03; p-interaction = 0.034). Conclusions Higher perceived fatigability and fatigue symptoms were similarly associated with higher all-cause mortality, but utility differed by chronic condition. Perceived fatigability might be useful for health screening and long-term mortality risk assessment for well-functioning adults. Alternatively, self-reported fatigue appears more disease-specific with regards to mortality risk.

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Self‐assessed medication risk factors as part of comprehensive health screening in home‐dwelling older adults

Cited by 3 publications

References 32 publications

Medication risk checklist for older adults (LOTTA) – development and validation of a self-assessment tool

Medication risk checklist for older adults (LOTTA) – development and validation of a self-assessment tool

Harmonizing the definition of medication reviews for their collaborative implementation and documentation in electronic patient records: A Delphi consensus study

Perceived Fatigability, Fatigue, and Mortality in Mid-to-Late Life in the Baltimore Longitudinal Study of Aging

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