Medication adherence behaviors in older adults: Effects of external cognitive supports.

Park, Denise C.; Morrell, Roger W.; Frieske, David; Kincaid, Deborah

doi:10.1037/0882-7974.7.2.252

Cited by 128 publications

(113 citation statements)

References 14 publications

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“…About half of participants used a medication management tool, which is considerably less than in the USA (82%) (30). However, adherence aids (e.g., pill organizers) can improve drug adherence (31)(32)(33). Practical problems with medicine-taking (distinction between different drug packages, tablet swallowing and splitting, blister opening) were common.…”

Section: Practical Drug Management Capacitymentioning

confidence: 99%

Medication management among home-dwelling older patients with chronic diseases: Possible roles for community pharmacists

Mehuys

Dupond

Petrovic

et al. 2012

The Journal of nutrition, health and aging

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Objective: To describe medication management among home-dwelling older adults. These data should allow us to identify potential problems and to indicate target areas for community pharmacist intervention.Design: Cross-sectional observational study Setting: Community pharmacies (n=86) in Belgium.Participants: Home-dwelling older adults using at least one chronic medicine (n=338).Measurements: Data on drug use were taken from the electronic pharmacy databases, while drug adherence was measured by pill count, self-report and estimation by GP and pharmacist. Drug knowledge and practical drug management capacity were assessed by patient interview and questionnaire, respectively. Results:The study population (n=338) used a median of 5 chronic drugs per patient. Half of our sample (n=169) used psychotropic medication chronically, mainly benzodiazepines. In 100 patients (29.6%) at least one drug-drug interaction of potential clinical significance was observed. The overall mean adherence per patient was very high (98.1%), but 39.6% of individuals was underadherent with at least one medication. Seventy-six % of patients had an acceptable knowledge of the indication for at least 75% of their medication. In nearly 15 % of the study population cognitive impairment was suspected by the Mini-Cog Test. The participants reported several practical problems with drug taking: difficulties with vision (32.0%), blister opening (12.1%), tablet swallowing (14.8%), tablet splitting (29.7% [represents % of patients who have to split tablets]) and distinction between different drug packages (23.4%). Conclusion:This study identified the following aspects of medication management by home-dwelling older adults that could be improved by pharmaceutical care services: (i) assistance of cognitively impaired patients, (ii) management of practical drug taking problems, (iii) DDI screening, (iv) drug adherence, and (v) chronic benzodiazepine use.3

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Section: Practical Drug Management Capacitymentioning

confidence: 99%

Medication management among home-dwelling older patients with chronic diseases: Possible roles for community pharmacists

Mehuys

Dupond

Petrovic

et al. 2012

The Journal of nutrition, health and aging

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“…There is little evidence supporting best practices for writing prescription medication dosage instructions to promote patients' understanding of use. Data from our previous study and earlier cognitive factors research suggest that less complex and more explicit dosage instructions might improve patient understanding 4,7,[11][12][13][14][15] . The purpose of this study was to evaluate whether the use of more explicit language to describe the dose and frequency of prescribed drugs could improve comprehension, especially among patients with limited literacy.…”

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confidence: 99%

Improving Patient Understanding of Prescription Drug Label Instructions

et al. 2008

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“…These failures reveal that the cues spontaneously utilized by learners do not flawlessly support retrieval. Weekly phone calls, pill boxes, and beepers have been implemented to improve medication adherence, and these interventions often succeed in increasing the rates with which patients consistently take their prescription (Lachowsky & Levy-Toledano, 2002;Park et al, 1992;Piette et al, 2001). This evidence shows that the quality of the cue makes a big difference in whether target information is recalled and desired tasks are completed.…”

Section: Qualities Of Good Cuesmentioning

confidence: 99%

“…Harris (1980) surveyed learners about the external cues used to aid retrieval and found widespread use of a variety of different external aids, including putting items in special places to remind them of something, writing on a calendar, making notes to oneself, and asking others to remind them. The effectiveness with which learners use such external support has been most thoroughly examined with respect to prescription adherence (Caranasos et al, 1974), and has shown that learners often fail to utilize effective external cues (Haynes, McKibbon, & Kanani, 1996;Park, Morrell, Frieske, & Kincaid, 1992;Piette, Weinberger, Kraemer, & McPhee, 2001). Generating effective cues requires that learners set up circumstances to enhance the probability of being reminded of the appropriate action (Tullis, Braverman, Ross, & Benjamin, 2014;Tullis, Benjamin, & Ross, 2014) rather than merely increase the current memory strength of the target item.…”

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confidence: 99%

Cue generation: How learners flexibly support future retrieval

Tullis

Benjamin

2015

Mem Cogn

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The successful use of memory requires us to be sensitive to the cues that will be present during retrieval. In many situations, we have some control over the external cues that we will encounter. For instance, learners create shopping lists at home to help remember what items to later buy at the grocery store, and they generate computer file names to help remember the contents of those files. Generating cues in the service of later cognitive goals is a complex task that lies at the intersection of metacognition, communication, and memory. In this series of experiments, we investigated how and how well learners generate external mnemonic cues. Across 5 experiments, learners generated a cue for each target word in a to-be-remembered list and received these cues during a later cued recall test. Learners flexibly generated cues in response to different instructional demands and study list compositions. When generating mnemonic cues, as compared to descriptions of target items, learners produced cues that were more distinct than mere descriptions and consequently elicited greater cued recall performance than those descriptions. When learners were aware of competing targets in the study list, they generated mnemonic cues with smaller cue-to-target associative strength but that were even more distinct. These adaptations led to fewer confusions among competing targets and enhanced cued recall performance. These results provide another example of the metacognitively sophisticated tactics that learners use to effectively support future retrieval.Keywords Cue generation . Metacognition . Control When taking notes in meetings, making to-do lists, outlining readings, and naming computer files, learners support later retrieval by generating cues for their future selves. Learners create external cues to reduce the demands placed on their limited memories. The ability of a learner to remember target information may fade over time; a good external cue can sustain memory retrieval in the face of considerable forgetting. Generating external cues to support later retrieval plays a vital role in many real-world activities and carries serious consequences. For example, patients often set up memory cues, like pill boxes and cell phone reminders, to aid in their adherence to medications. In the current experiments, we examined how learners generate cues to support later memory retrieval. More specifically, we analyzed how the characteristics of selfgenerated cues differed under various instructional conditions and with various stimulus sets. In the first trio of experiments (Experiments 1-3), we examined how learners intentionally generate cues for themselves and evaluated the characteristics of intentional mnemonic cues. In the second series of experiments (Experiments 4-5) we analyzed whether learners adjust their cues based upon the characteristics of the to-beremembered set of stimuli.Although there is not a large body of research on cue generation in mnemonic tasks, learners must exercise accurate metacognitive control wh...

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Medication adherence behaviors in older adults: Effects of external cognitive supports.

Cited by 128 publications

References 14 publications

Medication management among home-dwelling older patients with chronic diseases: Possible roles for community pharmacists

Medication management among home-dwelling older patients with chronic diseases: Possible roles for community pharmacists

Improving Patient Understanding of Prescription Drug Label Instructions

Cue generation: How learners flexibly support future retrieval

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