Development of a medication literacy assessment instrument (MELIA) for older people receiving home care

Abstract

Aim: To develop a consensus-based instrument [MELIA] to assess the medication literacy of older home care patients to ultimately optimize medication safety.Design: This study was part of the project 'Study of Medication Safety in Home Care' (doMESTIC), which took place from 2016 to 2020 in Switzerland. The development process for the medication literacy assessment instrument encompassed six steps.Method: First, a scoping literature search was conducted in the Pubmed, CINAHL, EMBASE and Cochrane Library databases as 2) a basis for the development of assessment items. This was followed by 3) a cognitive interview with home care patients and 4) the first round of a Delphi process. Then, 5) a focus group interview with home care experts was conducted before 6) the second Delphi round. The project took place between August 2020 and June 2021. With these different steps, perspectives of both patients and various home care and medication safety experts were included in the development of the assessment instrument. Results:A detailed instrument consisting of 20 items as well as a 7-item short version were developed. The short version is intended for efficient preliminary screening to identify patients at high risk for medication management-related problems. Conclusion: Medication literacy in patients 65 years and older receiving professional home care is a key issue in preventing medication errors. A targeted assessment, starting with an efficient short version of MELIA, allows for prioritization of patients for interventions to optimize medication safety while ensuring their independence as much as possible. Impact: Systematic assessment of patients' medication literacy helps to provide them with targeted and individual support in their medication management to avoid medication errors and increase patient safety. The development of MELIA is a first step in providing an assessment instrument specifically for the home care setting. Patient or public contribution: Patient participation was an integral part of the instrument development. The initial 23 items were optimized based on cognitive interviews with four home care patients. The next steps of the instrument development were based on feedback of health care professionals-encompassing advance practice

Uma Revisão De Escopo Sobre O Cuidado Farmacêutico Ao Idoso Na Assistência Domiciliar

“…Com a compreensão do tratamento, o paciente adquire maior autonomia para seguir com o tratamento corretamente. Os outros serviços clínicos ofertados pelo farmacêutico contemplam: o acompanhamento farmacoterapêutico; a conciliação medicamentosa que auxilia no processo de alta hospitalar e na adesão medicamentosa; educação em saúde que envolve estratégias educativas para melhora dos problemas de saúde; e rastreamento em saúde que serve como prevenção no caso do paciente desenvolver alguma doença (13,39).…”

“…A polifarmácia e baixa compreensão da farmacoterapia são um dos fatores de risco mais prevalentes em pacientes idosos. E os serviços de atendimento domiciliar são cada vez mais encarregados de administrar complexas terapias medicamentosas (39). Diante desse cenário, o serviço clínico do farmacêutico durante o atendimento domiciliar, com a identificação e resolução dos PRMs, assim, melhora da efetividade do tratamento e segurança no uso dos medicamentos.…”

Factors affecting the medication literacy of older adults and targeted initiatives for improvement: a cross-sectional study in central China

“…Given their propensity for suffering from multiple diseases and concurrently taking various drugs, older adults represent a main population of irrational drug use (14)(15)(16). Therefore, it is necessary to understand the current situation of rational drug use among older adults and to analyze factors affecting their medication safety (14,17).…”