Validity of the medication administration test among older adults with and without dementia

Schmidt, Kara S.; Lieto, Janet

doi:10.1016/j.amjopharm.2005.12.003

Cited by 15 publications

(16 citation statements)

References 23 publications

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“…Administration time may be longer in patients with cognitive impairment, and more variable for instruments that use patients' own medications because of the variable number of medications [ 55 ]. Five instruments had a time limit or timed component [ 42 , 45 , 49 - 51 ].…”

Section: Resultsmentioning

confidence: 99%

“…In other cases, the rater was blinded to some, but usually not all, patient data [ 39 , 46 , 48 , 49 , 56 ]. Most studies did not adequately describe reasons for patient exclusion or their characteristics relative to the study subjects [ 40 - 43 , 45 - 49 , 51 ], or whether study subjects were currently managing their own medications [ 42 - 44 , 46 - 51 ], making generalisation of findings difficult and introducing potential spectrum bias [ 13 , 18 , 57 ]. In six studies the reference standard was not applied to all subjects [ 9 , 44 , 45 , 47 - 49 ].…”

Section: Resultsmentioning

confidence: 99%

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Standardised assessment of patients' capacity to manage medications: a systematic review of published instruments

Elliott

Marriott

2009

BMC Geriatr

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BackgroundOlder people are commonly prescribed complex multi-drug regimens while also experiencing declines in the cognitive and physical abilities required for medication management, leading to increased risk of medication errors and need for assisted living. The purpose of this study was to review published instruments designed to assess patients' capacity to self-administer medications.MethodsSearches of Medline, EMBASE, CINAHL, PsycINFO, International Pharmaceutical Abstracts, Health and Psychosocial Instruments, Google, and reference lists of identified publications were conducted to identify English-language articles describing development and validation of instruments designed to assess patients' capacity to self-administer medications. Methodological quality of validation studies was rated independently against published criteria by two reviewers and reliability and validity data were reviewed.ResultsThirty-two instruments were identified, of which 14 met pre-defined inclusion criteria. Instruments fell into two categories: those that used patients' own medications as the basis for assessment and those that used a simulated medication regimen. The quality of validation studies was generally low to moderate and few instruments were subjected to reliability testing. Most instruments had some evidence of construct validity, through associations with tests of cognitive function, health literacy, activities of daily living or measures of medication management or adherence. Only one instrument had sensitivity and specificity data with respect to prediction of medication-related outcomes such as adherence to therapy. Only three instruments had validity data from more than one independent research group.ConclusionA number of performance-based instruments exist to assess patients' capacity to manage their own medications. These may be useful for identifying physical and cognitive barriers to successful medication management, but further studies are needed to determine whether they are able to accurately and reliably predict medication outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Standardised assessment of patients' capacity to manage medications: a systematic review of published instruments

Elliott

Marriott

2009

BMC Geriatr

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“…A relatively low sensitivity of 0.47 in item 7 (self-medication) is rather unexpected, because previous studies suggested that self-medication is one of the early signs of dementia [19,20,21,22,23,24]. Possible causes for this discrepancy could be that some patients may have developed long-term habits of medication, e.g., antihypertensive drugs, while others may not have taken any medications, as the questionnaire was filled out at the initial visit.…”

Section: Discussionmentioning

confidence: 99%

Symptoms of Early Dementia-11 Questionnaire (SED-11Q): A Brief Informant-Operated Screening for Dementia

Maki

Yamaguchi

2013

Dement Geriatr Cogn Disord Extra

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The aim of this study was to develop a brief informant-based questionnaire, namely the Symptoms of Early Dementia-11 Questionnaire (SED-11Q), for the screening of early dementia. 459 elderly individuals participated, including 39 with mild cognitive impairment in the Clinical Dementia Rating scale (CDR) 0.5, 233 with mild dementia in CDR 1, 106 with moderate dementia in CDR 2, and 81 normal controls in CDR 0. Informants were required to fill out a 13-item questionnaire. Two items were excluded after analyzing sensitivities and specificities. The final version of the SED-11Q assesses memory, daily functioning, social communication, and personality changes. Receiver operator characteristic curves assessed the utility to discriminate between CDR 0 (no dementia) and CDR 1 (mild dementia). The statistically optimal cutoff value of 2/3, which indicated a sensitivity of 0.84 and a specificity of 0.90, can be applied in the clinical setting. In the community setting, a cutoff value of 3/4, which indicated a sensitivity of 0.76 and a specificity of 0.96, is recommended to avoid false positives. The SED-11Q reliably differentiated nondemented from demented individuals when completed by an informant, and thus is practical as a rapid screening tool in general practice, as well as in the community setting, to decide whether to seek further diagnostic confirmation.

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“…Those participants able to consent underwent an evaluation of medication management skills prior to discharge from the SNF to home using two instruments, which included: the Medication Administration Test (MAT) (using mock prescription vials/labels and tablets with a 10 medication regimen, the resident's ability to adhere with a hypothetical 24-hour day was evaluated), and the Medi-Cog (a combination of the Mini-Cog and a Medication Transfer Screen, which assessed the resident's ability to transfer medications to a pillbox). 6,7 Descriptive statistics were used to summarize the results. The University of Pittsburgh institutional review board approved this study.…”

Section: Methodsmentioning

confidence: 99%

Medication Management Skills in Older Skilled Nursing Facility Residents Transitioning Home

Marcum

Hardy²

2015

J American Geriatrics Society

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Validity of the medication administration test among older adults with and without dementia

Cited by 15 publications

References 23 publications

Standardised assessment of patients' capacity to manage medications: a systematic review of published instruments

Standardised assessment of patients' capacity to manage medications: a systematic review of published instruments

Symptoms of Early Dementia-11 Questionnaire (SED-11Q): A Brief Informant-Operated Screening for Dementia

Medication Management Skills in Older Skilled Nursing Facility Residents Transitioning Home

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