Longitudinal Investigation of Older Adults' Ability to Self‐Manage Complex Drug Regimens

• Published in: Journal of the American Geriatrics Society (JAGS) 2020-03, Vol.68 (3), p.569-575
• Main Authors: Bailey, Stacy Cooper, Opsasnick, Lauren A., Curtis, Laura M., Federman, Alex D., Benavente, Julia Y., O'Conor, Rachel, Wolf, Michael S.
• Format: Article
• Language: English
• Subjects: Aged; Aging; Chronic Disease - therapy; Chronic illnesses; Cognitive ability; Cohort Studies; Cross-Sectional Studies; Dosage; Drug dosages; Female; Health Literacy; Humans; Longitudinal Studies; Male; medication safety; Middle Aged; Older people; Pharmaceutical Preparations; polypharmacy; Self-Management
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/jgs.16255

OBJECTIVES We sought to investigate older patients' ability to correctly and efficiently dose multidrug regimens over nearly a decade and to explore factors predicting declines in medication self‐management. DESIGN Longitudinal cohort study funded by the National Institute on Aging. SETTING One academic internal medicine clinic and six community health centers. PARTICIPANTS Beginning in 2008, 900 English‐speaking adults, aged 55 to 74 years, were enrolled in the study, completing a baseline (T1) assessment. To date, 303 participants have completed the same assessment 9 years postbaseline (T4). MEASUREMENTS At T1, subjects were given a standardized, seven‐drug regimen and asked to demonstrate how they would take medicine over 24 hours. The number of dosing errors made and times per day that a participant would take medicine were recorded. Health literacy was measured via the Newest Vital Sign, and cognitive decline was measured by the Mini‐Mental State Examination. RESULTS Participants on average made 2.9 dosing errors (SD = 2.5 dosing errors; range = 0‐21 dosing errors) of 21 potential errors at T1 and 5.0 errors (SD = 2.1 errors; range = 1‐18 errors; P