gms | German Medical Science

Background: Older people often suffer from medication management problems due to multimorbidity, polypharmacy and medication complexity. The patients’ self-reported abilities to handle the self-administration of their medication differs from their actual performance. Because adequate medication management is obligatory to achieve effective pharmacotherapy, we report on the development of a new tool to assess the ability of non-demented hospitalized patients to self-administer medication in different dosage forms.

Materials and Methods: One hundred patients ≥ 70 years of age and regularly taking ≥ 5 different drugs autonomously took part of the ABLYMED study. Besides demographic information, medication history, geriatric assessment, and medication adherence we assessed self-reported medication management problems via interview and actual medication management problems via video-based evaluation of patient’s medication management skills in five different placebo dosage forms. We related the observed actual performance in the self-administration tasks to medication and patient related factors from the study which may influence the ability to self- administer medication, using Sperman’s Rho and multivariable linear regressions models.

Results: We obtained significant correlations (p < 0,05) between video-based measure of actual performance in medication management expressed in a sum score consider performance in all dosage forms and the following medication and patient related factors: the time to complete in Zahlen-Verbindungs-Test (ZVT-G) (ρ=0,384), Timed Test of Money Counting (ρ=0,453), Clock-drawing test (ρ=0,356), time estimation (ρ=0,314), number of drops right hand of The grooved pegboard test (ρ=-0,285), grip strength (ρ=-0,272), tip pinch strength (ρ=-0,336), age (ρ=0,326), IADL scale (ρ=-0,030) and the medication management instrument for deficiencies in the elderly (MedMaIDE) (ρ=-0,332). Performing linear regression, age (b=0,254) and ZVT-G (b=0,073) remained in the model.

Conclusion: Our research suggested that higher age and lower information processing speed measured by ZVT-G are associated with poorer ability to self-administer medication. Further investigations will expose the consequences of these findings for geriatric assessments and medication prescription.