Medication Management Assessment for Older Adults in the Community

Abstract

Purpose: The purpose of this study was to describe the Medication Management Instrument for Deficiencies in the Elderly (MedMaIDE) and to provide results of reliability and validity testing. Design and Methods: Participants were 50 older adults, aged 65 and older, who lived in the community, took at least one prescription medication, and were then self-medicating. Nonmedical study staff assessed participants in their homes at baseline and 1 week, and a study pharmacist conducted pill counts at baseline and 30 days. The MedMaIDE covers three domains important for ensuring medication compliance (knowledge of medications, how to take medications, and procurement) and yields a total deficiency score. We assessed test-retest and interrater reliability. We assessed validity by comparing the MedMaIDE deficiency scores to 30-day pill count compliance. Results: The sample was mostly female (72%) and White (56%), with a mean age of 78. Participants were taking an average of 7 prescription drugs, with an average pill count compliance of 70%. The MedMaIDE had very good test-retest reliability (intraclass correlation coefficient [ICC] = 0.93) and good interrater reliability (ICC = 0.74). Internal consistency was also strong (Cronbach's alpha = .71). Comparing the MedMaIDE to the pill count with those who were compliant (.80%) versus those that were not, the agreement was 75%. The MedMaIDE was more highly specific and predictive of compliance compared to the pill count. Implications: The MedMaIDE appears to be a reliable and valid instrument for determining if an older adult has deficiencies in managing medications.

Basic Knowledge of the Medication Regimen Correlates with Performance on Cognitive Function Tests and Diagnosis of Dementia in Elderly Patients Referred to a Geriatric Assessment Unit

“…All others were considered to lack basic knowledge of the medication regimen. Although different tools for assessing medication management have been used [10,11] , we applied the above test because, in our view, basic knowledge of the medication regimen, as defined above, embodies a minimal requirement for correct use of medications.…”

Association Between Unmet Needs for Medication Support and All‐Cause Hospitalization in Community‐Dwelling Disabled Elderly People

“…[5][6][7] However, it remains unclear whether unmet medication management need is associated with poor outcome for community-dwelling older people with various levels of disabilities.…”

An intervention to maximize medication management by caregivers of persons with memory loss: Intervention overview and two-month outcomes

“…The Medication Management Instrument for Deficiencies in the Elderly (MedMaIDE) 22 uses a combination of interview and observation to assess a caregiver’s knowledge of medications, how to take medications, and how to procure medications. Each medication that the person is taking is reviewed during administration of this tool and 13 of the items are scored and summed, resulting in a score with a possible range from 0 to 13 where high scores indicating more deficiencies across the medications.…”