ArticleSAGE open medicine2017
Medication self-management skills and cognitive impairment in older adults hospitalized for heart failure: A cross-sectional study.
Article in SAGE open medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Interventions for self-management of medicines for community-dwelling people with dementia and mild cognitive impairment and their family carers: a systematic review.Age and ageing · 2022Pooled it
- The feasibility of the enhancing medicines self-management for community dwelling people living with dementia and family carers (MAGNET) psychosocial intervention: protocol for a non-randomised feasibility study.Pilot and feasibility studies · 2025Article
- Assessing patient work system factors for medication management during transition of care among older adults: an observational study.BMJ quality & safety · 2024Observational
- Feasibility of a Multidomain Resiliency Assessment in Patients With Advanced Heart Failure Requiring Surgery: A Pilot Study.Physical therapy · 2024Article
- 'It's a job to be done'. Managing polypharmacy at home: A qualitative interview study exploring the experiences of older people living with frailty.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Fatigue, Stress, and Blood Pressure Medication Adherence by Race After Myocardial Infarction.The journal for nurse practitioners : JNP · 2023Article
- Real-world safety of neurohormonal antagonist initiation among older adults following a heart failure hospitalization.ESC heart failure · 2023Observational
- A rapid review of interventions to improve medicine self-management for older people living at home.Health expectations : an international journal of public participation in health care and health policy · 2023Review
- Risk evaluation of cognitive impairment in patients with heart failure: A call for action.International journal of cardiology. Heart & vasculature · 2022Article
- Medication Complexity Among Older Adults with HF: How Can We Assess Better?Drugs & aging · 2022Review
- Cognitive Dysfunction in Heart Failure: Pathophysiology and Implications for Patient Management.Current heart failure reports · 2022Review
- Acute heart failure in the elderly: setting related differences in clinical features and management.Journal of geriatric cardiology : JGC · 2021Article
- Developing patient-centric medicines for older people: Reflections from the draft EMA paper on the pharmaceutical development of medicines for use in the older population.British journal of clinical pharmacology · 2020Review
- Prospective assessment of combined handgrip strength and Mini-Cog identifies hospitalized heart failure patients at increased post-hospitalization risk.ESC heart failure · 2018Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCognitive impairment is highly prevalent among older adults (aged ≥65 years) hospitalized for heart failure and has been associated with poor outcomes. Poor medication self-management skills have been associated with poor outcomes in this population as well. The presence and extent of an association between cognitive impairment and poor medication self-management skills in this population has not been clearly defined.
objectiveWe assessed the cognition of consecutive older adults hospitalized for heart failure, in relation to their medication self-management skills.
methodsWe conducted a cross-sectional study of older adults (aged ≥65 years) who were hospitalized for heart failure and were being discharged home. Prior to discharge, we assessed cognition using the Mini-Cog. We also tested patients' ability to read a pill bottle label, open a pill bottle safety cap, and allocate mock pills to a pill box. Pill allocation performance was assessed quantitatively (counts of errors of omission and commission) and qualitatively (patterns suggestive of knowledge-based mistakes, rule-based mistakes, or skill-based slips).
resultsOf 55 participants, 22% were found to have cognitive impairment. Patients with cognitive impairment tended to be older as compared to those without cognitive impairment (mean age = 81 vs 76 years, p = NS). Patients with cognitive impairment had a higher prevalence of inability to read pill bottle label (prevalence ratio = 5.8, 95% confidence interval = 3.2-10.5, p = 0.001) and inability to open pill bottle safety cap (prevalence ratio = 3.3, 95% confidence interval = 1.3-8.4, p = 0.03). While most patients (65%) had pill-allocation errors regardless of cognition, those patients with cognitive impairment tended to have more errors of omission (mean number of errors = 48 vs 23, p = 0.006), as well as more knowledge-based mistakes (75% vs 40%, p = 0.03).
conclusionThere is an association between cognitive impairment and poor medication self-management skills. Medication taking failures due to poor medication self-management skills may be part of the pathway linking cognitive impairment to poor post-discharge outcomes among patients with heart failure transitioning from hospital to home.
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