# Factors associated with medication self-management performance in the “Ability to Self-administer Medication in Non-demented In-hospital Patients” (ABLYMED) study

## TL;DR

This study identifies age and cognitive speed as key factors affecting older patients' ability to self-manage medications in hospitals.

## Contribution

The study empirically links cognitive and motor factors to medication self-management performance in older hospitalized patients.

## Key findings

- Higher age and lower information processing speed are associated with poorer medication self-administration.
- Cognitive and motor impairments negatively impact medication management in older adults.
- Age and ZVT-G scores remained significant in a multivariable model of medication performance.

## Abstract

Older people often suffer from medication management problems due to multimorbidity, polypharmacy and medication complexity. Because of frequent discrepancies between self-reported and actual abilities to self-administer prescribed medications, these problems often go unnoticed. To secure adequate medication management for effective pharmacotherapy, it is important to understand which factors possibly influence medication self-management performance. As part of a large-scale study on the “Ability to Self-administer Medication in Non-demented In-hospital Patients” (ABLYMED), we addressed this question by assessing medication- and patient-related factors with a possible influence on medication self-management in 100 patients ≥ 70 years of age regularly taking ≥ 5 different medicines autonomously.

Medication management performance was assessed in five different placebo dosage forms via standardized video-based evaluation expressed in an overall performance rating score. Data from 57 patients (median age 78, Q1; Q3 = 73;82 years) could be used for subsequent analyses. To analyze which factors are associated with performance in medication management, we calculated correlations of different medication- (e.g. complexity, adequacy in older age) and patient-related factors (e.g. adherence, cognition, motor abilities, burden of disease, age, sex) with self-administration performance and included all factors with significant correlations in a stepwise multivariable linear regression model.

We observed significant correlations between the video-based measure of performance in medication management and the following patient-related factors: cognition, manual dexterity, functional state, activities of daily living and age. When performing multivariable linear regression stepwise selection, age and ZVT-G (test method for the construct cognition, especially information processing speed) remained in the model.

Our research suggests that cognitive and motor impairments in old age have a negative impact on medication management. Higher age and lower information processing speed are associated with poorer ability to self-administer medication. Further investigations will address the consequences of these findings for patient trainings, medication prescription procedures and careful control for problems in medication management and external help.

DRKS00025788, date of registration: 07/09/2021.