Development and Content Validation of an Instrument to Measure Medication Self-Management in Older Adults

Background: For older adults, the capacity to self-manage medications may be limited by several factors. However, currently available tools do not permit a comprehensive assessment of such limitations. The Domain Specific Limitation in Medication Management Capacity (DSL-MMC) was developed to address this need. This study aimed to establish the face and content validity of the DSL-MMC. Methods: The DSL-MMC tool consisted of 4 domains and 12 sub-domains with 42 items including: 1. physical abilities (vision, dexterity, hearing); 2. cognition (comprehension, memory, executive functioning); 3. medication regimen complexity (dosing regimen, non-oral administration, polypharmacy); and 4. access/caregiver (prescription refill, new prescription, caregiver). Pharmacists assessed each item for relevance, importance, readability, understandability, and representation. Items with content validity index (CVI) scores of <0.80 for relevance were examined for revision or removal. Results: Twelve pharmacists participated in the study. CVI scores for relevance and importance of domains were 1.0; of the sub-domains, two were below 0.80. Among the 42 items, 35 (83%) and 30 (71%) maintained CVI scores above 0.80 for relevance and importance, respectively. Five items were removed, three were merged and seven were modified due to low CVI scores and/or feedback. Conclusion: The DSL-MMC has been validated for content.

Medication Management Capacity Among Older Residents of Low-Income Apartment Buildings

MMC is an essential component of safe and independent living. This cross-sectional study was designed to assess MMC among low-income older persons residing in HUD-subsidized housing, located at one of five apartment buildings in urban Richmond, VA. Medication Management Instrument for Deficiencies in the Elderly (MedMaIDE) was used to measure MMC during individual, face-to-face interviews. Of the 107 participants, 89% were African-American with an average age of 68.5 years (±7.2), an average of 4.9 (±2.9) comorbidities and using approximately 8 (±4.1) medications on a regular basis. The mean deficit in MMC was 3 (±2.0). The most difficult skill was naming all of the medications (69.2%) followed by stating the indication (46.7%) and knowing how or when all of the medications should be taken or identifying existing refills (38.3%). Many older residents of low-income housing experience challenges in managing medications.

Level of medication self-management capacity among patients on ambulatory care exiting hospital pharmacy at Muhimbili National hospital, Tanzania: a descriptive cross-sectional study

Objectives: Medication management capacity of a patient on ambulatory care is direct related to adherence. To our knowledge data on medication management capacity for ambulatory care patients exiting outpatient pharmacy outlets in Tanzania are scarce. This study aimed to determine the level of medication management capacity among patients on ambulatory care exiting Muhimbili National Hospital outpatient pharmacy outlet. Results: A total of 424 patients on ambulatory care participated in the study. Three hundred eighty seven (91.3%) out of 424 interview questionnaires had complete data and qualified for data analysis. Majority (62.3%) out of 387 study participants had poor medication management capacity; 65.3% out of 387 patients were unable to correctly read the prescription and match the drugs they are carrying. More than half (57.4%) out of 387 participants were unable to correctly take the dose, 73.9% out of 387 were unable to correctly tell the dosing frequency and duration. Only 10.6% out 155 patients with prescription containing drugs with warning or precaution or contraindication or potential side effects were aware.

Level of medication self-management capacity among patients on ambulatory care exiting hospital pharmacy at Muhimbili National hospital, Tanzania: a descriptive cross-sectional study

Objectives: Medication management capacity of a patient on ambulatory care is direct related to adherence. To our knowledge data on medication management capacity for ambulatory care patients exiting outpatient pharmacy outlets in Tanzania are scarce. This study aimed to determine the level of medication management capacity among patients on ambulatory care exiting Muhimbili National Hospital outpatient pharmacy outlet. Results: A total of 424 patients on ambulatory care participated in the study. Three hundred eighty seven (91.3%) out of 424 interview questionnaires had complete data and qualified for data analysis. Majority (62.3%) out of 387 study participants had poor medication management capacity; 65.3% out of 387 patients were unable to correctly read the prescription and match the drugs they are carrying. More than half (57.4%) out of 387 participants were unable to correctly take the dose, 73.9% out of 387 were unable to correctly tell the dosing frequency and duration. Only 10.6% out 155 patients with prescription containing drugs with warning or precaution or contraindication or potential side effects were aware.

Level of medication self-management capacity among patients on ambulatory care exiting hospital pharmacy at Muhimbili National Hospital, Tanzania: a descriptive cross-sectional study

Objectives Medication management capacity of a patient on ambulatory care is direct related to adherence. To our knowledge data on medication management capacity for ambulatory care patients exiting outpatient pharmacy outlets in Tanzania are scarce. This study aimed to determine the level of medication management capacity among patients on ambulatory care exiting Muhimbili National Hospital outpatient pharmacy outlet. Results A total of 424 patients on ambulatory care participated in the study. Three hundred eighty-seven (91.3%) out of 424 interview questionnaires had complete data and qualified for data analysis. Majority (62.3%) out of 387 study participants had poor medication management capacity; 65.3% out of 387 patients were unable to correctly read the prescription and match the drugs they are carrying. More than half (57.4%) out of 387 participants were unable to correctly take the dose, 73.9% out of 387 were unable to correctly tell the dosing frequency and duration. Only 10.6% out 155 patients with prescription containing drugs with warning or precaution or contraindication or potential side effects were aware.

Level of medication self-management capacity among patients on ambulatory care exiting hospital pharmacy at Muhimbili National hospital, Tanzania: a descriptive cross-sectional study

Objectives Medication management capacity of a patient on ambulatory care is direct related to adherence. To our knowledge data on medication management capacity for ambulatory care patients exiting outpatient pharmacy outlets in Tanzania are scarce. This study aimed to determine the level of medication management capacity among patients on ambulatory care exiting Muhimbili National Hospital outpatient pharmacy outlet.Results Majority (62.3%) of the patients on ambulatory care had poor medication management capacity; 65.3% out of 387 patients were unable to correctly read the prescription and match the drugs they are carrying. More than half (57.4%) were unable to correctly take the dose, 57.4% were unable to correctly tell the dosing frequency and duration. Only 10.6% out 155 patients with prescription containing drugs with warning or precaution or contraindication or potential side effects were aware.

Medication Management Capacity and Its Neurocognitive Correlates in Huntington’s Disease

Objective Although medication management is a necessary daily activity for individuals with Huntington’s disease (HD), medication management abilities and their relation to cognitive functioning have not been evaluated. Method Twenty individuals with HD and 20 healthy adults (HA) completed the Medication Management Abilities Assessment (MMAA). Individuals with HD also completed a self-report medication management measure and neuropsychological tests assessing executive function, retrospective memory, and prospective memory. Results Individuals with HD performed significantly poorer and made more undertaking errors on the MMAA as compared to HA. No group differences were found in overtaking errors. In the HD group, significant associations were found between undertaking errors and perceived medication management ability as well as between MMAA task performance and measures assessing prospective memory and executive functions. Conclusions Medication management capacity was negatively affected in individuals with HD and may be associated with difficulty remembering to take medications in the future.