Skip to main content

Advertisement

Log in

Assessment of the elderly’s functional ability to manage their medication: a systematic literature review

  • Review Article
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Background The evaluation of the elderly’s ability to manage medication through the use of a validated tool can be a significant step in identifying inabilities and needs, with the objective of increasing their self-care skills, and promoting successful aging. Aim of the review To identify studies assessing the elderly’s functional ability to manage their own medication. Method For the search strategy, the PICO method was used: P—Population (elderly), I—Instruments (tools for assessing medication management ability), C—Context (community) and O—Outcomes (functional ability to manage medication). The final search query was run in MEDLINE/PubMed, CINAHL Plus, ISI Web of Science and Scopus. The whole process was developed according to the PRISMA statement. Results The search retrieved 8051 records. In each screening stage, the selection criteria were applied to eliminate records where at least one of the exclusion criteria was verified. At the end of this selection, we obtained a total of 18 papers (17 studies). The results allow the conclusion to be drawn that studies use several different instruments, most of them not validated. The authors agree that medication management abilities decrease as cognitive impairment increases, even if a lot of studies assess only the physical dimension. DRUGS was the instrument most often used. Conclusion Older adults’ ability to manage their medication should be assessed using tools specifically built and validate for the purpose. DRUGS (which uses the real regimen taken by the elderly) was the most widely used assessment instrument in the screened studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Maddigan SL, Farris KB, Keating N, Wiens CA, Johnson JA. Predictors of older adults’ capacity for medication management in a self-medication program: a retrospective chart review. J Aging Health. 2003;15:332–52.

    Article  PubMed  Google Scholar 

  2. World Health Organization. Ageing and health technical report. Japan: Kobe; 2004.

    Google Scholar 

  3. Tordoff J, Simonsen K, Thomson WM, Norris PT. “It’s just routine”. A qualitative study of medicine-taking amongst older people in New Zealand. Pharm World Sci. 2010;32:154–61.

    Article  PubMed  Google Scholar 

  4. MacLaughlin EJ, Raehl CL, Treadway AK, Sterling TL, Zoller DP, Bond CA. Assessing medication adherence in the elderly—which tools to use in clinical practice? Drugs Aging. 2005;22(3):231–55.

    Article  PubMed  Google Scholar 

  5. Patterson TL, Lacro J, McKibbin CL, Moscona S, Hughs T, Jeste DV. Medication management ability assessment: results from a performance-based measure in older outpatients with schizophrenia. J Clin Psychopharmacol. 2002;22(1):11–9.

    Article  PubMed  Google Scholar 

  6. Elliott RA, Marriott JL. Standardised assessment of patients’ capacity to manage medications: a systematic review of published instruments. BMC Geriatr. 2009;9:27.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Farris KB, Phillips BB. Instruments assessing capacity to manage medications. Ann Pharmacother. 2008;42:1026–36.

    Article  PubMed  Google Scholar 

  8. Kucukarslan SN, Hagan AM, Shimp LA, Gaither CA, Lewis NJ. Integrating medication therapy management in the primary care medical home: a review of randomized controlled trials. Am J Health Syst Pharm. 2011;68(328):335–45.

    Article  PubMed  Google Scholar 

  9. Irvine-Meek J, Gould ON, Wheaton H, Todd LE. Acceptability and face validity of a geriatric self-medication assessment tool. Can J Hosp Pharm. 2010;63(3):225–32.

    PubMed  PubMed Central  Google Scholar 

  10. Irvine-Meek JM, Gould ON. Psychometric evaluation of a self-medication assessment tool in an elderly population. Can J Hosp Pharm. 2011;64(1):16–24.

    PubMed  PubMed Central  Google Scholar 

  11. Orwig D, Brandt N, Gruber-Baldini AL. Medication management assessment for older adults in the community. Gerontologist. 2006;46:661–8.

    Article  PubMed  Google Scholar 

  12. Carlson MC, Fried LP, Xue QL, Tekwe C, Brandt J. Validation of the Hopkins Medication Schedule to identify difficulties in taking medications. J Gerontol A Biol Sci Med Sci. 2005;60:217–23.

    Article  PubMed  Google Scholar 

  13. Schmidt KS, Lieto JM. Validity of the Medication Administration Test among older adults with and without dementia. Am J Geriatr Pharmacother. 2005;3:255–61.

    Article  PubMed  Google Scholar 

  14. Beckman AGK, Parker MG, Thorslund M. Can elderly people take their medicine? Patient Educ Couns. 2005;59:186–91.

    Article  PubMed  Google Scholar 

  15. Heaton RK, Marcotte TD, Mindt MR, Sadek J, Moore DJ, Bentley H, et al. The impact of HIV-associated neuropsychological impairment on everyday functioning. J Int Neuropsychol Soc. 2004;10(3):317–31.

    Article  PubMed  Google Scholar 

  16. Raehl CL, Bond CA, Woods T, Patry RA, Sleeper RB. Individualized drug use assessment in the elderly. Pharmacotherapy. 2002;22:1239–48.

    Article  PubMed  Google Scholar 

  17. Edelberg HK, Shallenberger E, Wei JY. Medication management capacity in highly functioning community-living older adults: detection of early deficits. J Am Geriatr Soc. 1999;47:592–6.

    Article  CAS  PubMed  Google Scholar 

  18. Albert SM, Weber CM, Todak G, Polanco C, Clouse R, McElhiney M, et al. An observed performance test of medication management ability in HIV: relation to neuropsychological status and medication adherence outcomes. AIDS Behav. 1999;3(2):121–8.

    Article  Google Scholar 

  19. Gurland BJ, Cross P, Chen JM, Wilder DE, Pine ZM, Lantigua RA, et al. A new performance-test of adaptive cognitive-functioning—the Medication Management (MM) Test. Int J Geriatr Psychiatry. 1994;9(11):875–85.

    Article  Google Scholar 

  20. Isaac LM, Tamblyn RM. Compliance and cognitive function: a methodological approach to measuring unintentional errors in medication compliance in the elderly. McGill-Calgary Drug Research Team. Gerontologist. 1993;33(6):772–81.

    Article  CAS  PubMed  Google Scholar 

  21. Romonko L, Pereles L. An evaluation of pharmacy assessment for geriatric patients. Can J Hosp Pharm. 1992;45(1):15–20.

    CAS  PubMed  Google Scholar 

  22. Meyer ME, Schuna AA. Assessment of geriatric patients’ functional ability to take medication. DICP. 1989;23:171–4.

    CAS  PubMed  Google Scholar 

  23. Murray MD, Darnell J, Weinberger M, Martz BL. Factors contributing to medication noncompliance in elderly public housing tenants. DICP. 1986;20(2):146–52.

    CAS  Google Scholar 

  24. Holly C, Salmond SW, Saimbert MK. Comprehensive systematic review for advanced nursing practice. Berlin: Springer; 2011.

    Google Scholar 

  25. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med. 2009;151:W65–94.

    Article  PubMed  Google Scholar 

  26. World Health Organization. Definition of an older or elderly person. 2015. http://www.who.int/healthinfo/survey/ageingdefnolder/en/. Accessed 1 Oct 2015.

  27. Edelberg HK, Shallenberger E, Hausdorff JM, Wei JY. One-year follow-up of medication management capacity in highly functioning older adults. J Gerontol A Biol Sci Med Sci. 2000;55:M550–3.

    Article  CAS  PubMed  Google Scholar 

  28. Beckman A, Bernsten C, Parker MG, Thorslund M, Fastbom J. The difficulty of opening medicine containers in old age: a population-based study. Pharm World Sci. 2005;27:393–8.

    Article  PubMed  Google Scholar 

  29. Ruscin JM, Semla TP. Assessment of medication management skills in older outpatients. Ann Pharmacother. 1996;30:1083–8.

    Article  CAS  PubMed  Google Scholar 

  30. Hutchison LC, Jones SK, West DS, Wei JY. Assessment of medication management by community-living elderly persons with two standardized assessment tools: a cross-sectional study. Am J Geriatr Pharmacother. 2006;4:144–53.

    Article  PubMed  Google Scholar 

  31. Cotrell V, Wild K, Bader T. Medication management and adherence among cognitively impaired older adults. J Gerontol Soc Work. 2006;47:31–46.

    Article  PubMed  Google Scholar 

  32. Farris KD, Kelly MW, Tryon J. Clock drawing test and medication complexity index as indicators of medication management capacity: a pilot study. J Am Pharm Assoc. 2003;43:78–81.

    Article  Google Scholar 

  33. Kripalani S, Henderson LE, Chiu EY, Robertson R, Kolm P, Jacobson TA. Predictors of medication self-management skill in a low-literacy population. J Gen Intern Med. 2006;21:852–6.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Lakey SL, Gray SL, Borson S. Assessment of older adults’ knowledge of and preferences for medication management tools and support systems. Ann Pharmacother. 2009;43:1011–9.

    Article  PubMed  Google Scholar 

  35. Lubinga SJ, Millar I, Babigumira JB. Pilot evaluation of the psychometric properties of a self-medication Risk Assessment Tool among elderly patients in a community setting. BMC Res Notes. 2011;4:398.

    Article  PubMed  PubMed Central  Google Scholar 

  36. McDougall GJ, Becker H, Vaughan PW, Acee TW, Delville CL. The revised direct assessment of functional status for independent older adults. Gerontologist. 2010;50:363–70.

    Article  PubMed  Google Scholar 

  37. Robnett RH, Dionne C, Jacques R, LaChance A, Mailhot M. The ManageMed Screening: an interdisciplinary tool for quickly assessing medication management skills. Clin Gerontol. 2007;30:1–23.

    Article  Google Scholar 

  38. Rostgaard T. Caring for children and older people in Europe—a comparison of European policies and practice. Policy Stud. 2002;23:51–68.

    Article  Google Scholar 

  39. Stauffer Y, Spichiger E, Mischke C. Complex drug regimen in multimorbid elderly patients after hospital discharge—a qualitative study. Pflege. 2015;28:7–18.

    Article  PubMed  Google Scholar 

  40. Atkin PA, Finnegan TP, Ogle SJ, Shenfield GM. Functional ability of patients to manage medication packaging: a survey of geriatric inpatients. Age Ageing. 1994;23:113–6.

    Article  CAS  PubMed  Google Scholar 

  41. Bevil CW. Medication management in an elderly, community-based population: a pilot project. J N Y State Nurses Assoc. 1981;12:19–29.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

A special acknowledgement to Professor Nuno Lunet (University of Porto, ISPUP) for his support in the search query construction and to Dr. Rohan A. Elliott (Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University and Pharmacy Department, Austin Health, Australia) for his authorization to adapt assessed competences to Table 2.

Funding

None.

Conflicts of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ana Margarida Advinha.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Advinha, A.M., Lopes, M.J. & de Oliveira-Martins, S. Assessment of the elderly’s functional ability to manage their medication: a systematic literature review. Int J Clin Pharm 39, 1–15 (2017). https://doi.org/10.1007/s11096-016-0409-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-016-0409-z

Keywords

Navigation