Development and Content Validation of an Instrument to Measure Medication Self-Management in Older Adults

Abstract

Background: For older adults, the capacity to self-manage medications may be limited by several factors. However, currently available tools do not permit a comprehensive assessment of such limitations. The Domain Specific Limitation in Medication Management Capacity (DSL-MMC) was developed to address this need. This study aimed to establish the face and content validity of the DSL-MMC. Methods: The DSL-MMC tool consisted of 4 domains and 12 sub-domains with 42 items including: 1. physical abilities (vision, dexterity, hearing); 2. cognition (comprehension, memory, executive functioning); 3. medication regimen complexity (dosing regimen, non-oral administration, polypharmacy); and 4. access/caregiver (prescription refill, new prescription, caregiver). Pharmacists assessed each item for relevance, importance, readability, understandability, and representation. Items with content validity index (CVI) scores of <0.80 for relevance were examined for revision or removal. Results: Twelve pharmacists participated in the study. CVI scores for relevance and importance of domains were 1.0; of the sub-domains, two were below 0.80. Among the 42 items, 35 (83%) and 30 (71%) maintained CVI scores above 0.80 for relevance and importance, respectively. Five items were removed, three were merged and seven were modified due to low CVI scores and/or feedback. Conclusion: The DSL-MMC has been validated for content.

Tools to measure barriers to medication management capacity in older adults: a scoping review

“…While the measurement of MMC provides valuable insights into an individual's ability to handle medications effectively, it's essential to recognize its limitations [ 20 – 23 , 30 , 34 , 49 , 56 ]. This assessment doesn't offer a comprehensive prediction of real-world medication-taking behavior [ 101 , 102 ]. Medication non-adherence can be intentional or unintentional [ 6 – 9 ].…”

Cognitive, physical, and sensory deficits that can affect everyday medication use among older adults: A national view

“…There are additional factors that can impact a person's ability to manage medications. We described factors that were most pertinent to the act of taking medicines 9 . Limitations to our study include using survey measures that are not validated for medication management, inability to assess other impairments such as finger dexterity that can pose further challenges for medication use, accuracy of proxy responses, and not knowing the number and type of medications taken.…”