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Ibrahim NA, Wong YY, Lean QY, Ramasamy K, Lim SM, Tan MP, Abdul Majeed AB. Medication self-management among older adults with cognitive frailty. Res Social Adm Pharm 2024; 20:172-181. [PMID: 37980238 DOI: 10.1016/j.sapharm.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/02/2023] [Accepted: 11/02/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Independent and safe medication self-management is essential for successful aging. Nevertheless, how older adults with cognitive frailty (CF) self-manage medications at their own homes remain elusive. OBJECTIVE This study aimed at assessing the medication self-management capability of home-dwelling older adults with CF and exploring the ways, perceived challenges and barriers in medication self-management. METHODS A convergent mixed-method study design was used. The medication management capability of 16 CF individuals aged ≥ 60 years on ≥ 1 long-term prescription drugs were assessed using the Drug Regimen Unassisted Grading Scale (DRUGS). Virtual in-depth interviews were also performed between July-August 2022 using a semi-structured interview guide. All interviews were audio-recorded and transcribed verbatim. Qualitative data were analysed using a thematic analysis approach guided by Bailey and colleagues' model of medication self-management. RESULTS The mean DRUGS summary score was 96.86 [standard deviation (SD) 3.74] with highest performance scores observed in medication access (100 %) and lowest performance score in medication identification (91.46 %). Informants were able to independently take their medications and they tended to organise their medication intakes according to mealtime even though some admitted missing medication doses due to forgetfulness. Informants had difficulties with recalling drug names, with little awareness of self-monitoring their own health conditions and the effects of medications. Misconceptions towards medications, difficulties in accessing medications, reduced mobility and worsening health conditions could potentially deter informants from safe and independent medication self-management. In contrast, trust in doctors and a desire to achieve treatment goal could motivate medication self-management. CONCLUSION The findings revealed knowledge gaps among older adults with CF in identifying their medications and self-monitoring which warrant reinforcement by healthcare professionals to ensure chronic safe medication use. Future studies should evaluate strategies to enhance medication safety in terms of self-monitoring in individuals with CF.
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Affiliation(s)
- Nurul Alyaa Ibrahim
- Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Kampus Puncak Alam, 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia; Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Pulau Pinang, Bertam Campus, 13200 Kepala Batas, Pulau Pinang, Malaysia
| | - Yuet Yen Wong
- Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Pulau Pinang, Bertam Campus, 13200 Kepala Batas, Pulau Pinang, Malaysia; Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, University Teknologi MARA (UiTM) Cawangan Selangor, Kampus Puncak Alam, 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia.
| | - Qi Ying Lean
- Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Pulau Pinang, Bertam Campus, 13200 Kepala Batas, Pulau Pinang, Malaysia
| | - Kalavathy Ramasamy
- Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Kampus Puncak Alam, 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia; Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, University Teknologi MARA (UiTM) Cawangan Selangor, Kampus Puncak Alam, 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia
| | - Siong Meng Lim
- Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Kampus Puncak Alam, 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia; Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, University Teknologi MARA (UiTM) Cawangan Selangor, Kampus Puncak Alam, 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia
| | - Maw Pin Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Abu Bakar Abdul Majeed
- Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Kampus Puncak Alam, 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia; Brain Degeneration and Therapeutics Group, Faculty of Pharmacy, University Teknologi MARA (UiTM) Cawangan Selangor, Kampus Puncak Alam, 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia
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Alhusein N, Killick K, Macaden L, Smith A, Stoddart K, Taylor A, Kroll T, Watson MC. "We're really not ready for this": A qualitative exploration of community pharmacy personnel's perspectives on the pharmaceutical care of older people with sensory impairment. Disabil Health J 2018; 12:242-248. [PMID: 30392961 PMCID: PMC6436755 DOI: 10.1016/j.dhjo.2018.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 10/15/2018] [Accepted: 10/22/2018] [Indexed: 12/27/2022]
Abstract
Background In most developed countries there is an increasing ageing population living in the community with long-term conditions and sensory impairment (sight; hearing; dual impairment). Community pharmacy personnel are key providers of pharmaceutical care to this patient population. Objective This study explored community pharmacy personnel's experiences with providing pharmaceutical care for older people with sensory impairment. Methods Semi-structured telephone interviews were conducted with community pharmacy personnel across Scotland between 2015 and 2016. Results Thirty interviews were completed with community pharmacists (n = 17) and other pharmacy personnel (n = 13). Two overarching themes emerged: safety and communication. Interviewees reported patients' reluctance to disclose their impairment “patients are very good at hiding it” and had considerable safety concerns “it's a fear that they're going to take too much … accidentally taking the same medicine twice”. Difficulties in communication were cited “no matter what you do or how you label things, leaflets and telling people, things can go wrong”. Additionally, interviewees identified training needs to increase their disability awareness and to identify strategies to provide safe and reliable pharmaceutical care to this vulnerable group “We don't specifically have anything in place to deal with anyone with impairments of that kind”. Conclusions This is the first in-depth exploration of providing pharmaceutical care to older people with sensory impairment from the perspective of community pharmacy personnel. Strategies are needed to encourage older people to disclose their sensory impairment. Education and training are also needed to optimise the provision of pharmaceutical care to this vulnerable population.
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Affiliation(s)
- N Alhusein
- Department of Pharmacy and Pharmacology, University of Bath, Bath, BA27AY, England, UK.
| | - K Killick
- NMAHP Research Unit, Unit 13 Scion House, University of Stirling Innovation Park, University of Stirling, Stirling, Scotland, FK9 4NF, UK.
| | - L Macaden
- Department of Nursing, University of the Highlands & Islands, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, Scotland, UK.
| | - A Smith
- Department of Nursing, University of the Highlands & Islands, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, Scotland, UK.
| | - K Stoddart
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
| | - A Taylor
- Department of Pharmacy and Pharmacology, University of Bath, Bath, BA27AY, England, UK.
| | - T Kroll
- Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland.
| | - M C Watson
- Department of Pharmacy and Pharmacology, University of Bath, Bath, BA27AY, England, UK.
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