Factors associated with medication self-management performance in the "Ability to Self-administer Medication in Non-demented In-hospital Patients" (ABLYMED) study.

backgroundOlder people often suffer from medication management problems due to multimorbidity, polypharmacy and medication complexity. Because of frequent discrepancies between self-reported and actual abilities to self-administer prescribed medications, these problems often go unnoticed. To secure adequate medication management for effective pharmacotherapy, it is important to understand which factors possibly influence medication self-management performance. As part of a large-scale study on the “Ability to Self-administer Medication in Non-demented In-hospital Patients” (ABLYMED), we addressed this question by assessing medication- and patient-related factors with a possible influence on medication self-management in 100 patients ≥ 70 years of age regularly taking ≥ 5 different medicines autonomously.

methodsMedication management performance was assessed in five different placebo dosage forms via standardized video-based evaluation expressed in an overall performance rating score. Data from 57 patients (median age 78, Q1; Q3 = 73;82 years) could be used for subsequent analyses. To analyze which factors are associated with performance in medication management, we calculated correlations of different medication- (e.g. complexity, adequacy in older age) and patient-related factors (e.g. adherence, cognition, motor abilities, burden of disease, age, sex) with self-administration performance and included all factors with significant correlations in a stepwise multivariable linear regression model.

resultsWe observed significant correlations between the video-based measure of performance in medication management and the following patient-related factors: cognition, manual dexterity, functional state, activities of daily living and age. When performing multivariable linear regression stepwise selection, age and ZVT-G (test method for the construct cognition, especially information processing speed) remained in the model.

conclusionsOur research suggests that cognitive and motor impairments in old age have a negative impact on medication management. Higher age and lower information processing speed are associated with poorer ability to self-administer medication. Further investigations will address the consequences of these findings for patient trainings, medication prescription procedures and careful control for problems in medication management and external help. CLINICAL

trial registrationDRKS00025788, date of registration: 07/09/2021.