Lam Annie Y, Anderson Kitty, Borson Soo, Smith Forrest L
Department of Pharmacy, University of Washington, Seattle, Washington.
Consult Pharm. 2011 Apr;26(4):256-63. doi: 10.4140/TCP.n.2011.256.
To assess pillbox fill accuracy and cognition among community-dwelling older adults.
A descriptive, cross-sectional study.
Retail pharmacy.
Convenience sample of English-speaking adults older than 60 years of age without dementia, taking more than four medications, and naive to Mediset use.
In face-to-face interviews, subjects provided demographic, medical, and medication information, completed the Mini-Cog and Medi-Cog (combination of Mini-Cog and medication-transfer screen [MTS]), and filled their own medications in a pillbox. Data were analyzed using descriptive statistics and stepwise regression analysis with correctly filled pill count (PC) as the dependent variable and the cognitive screens as independent variables.
Accuracy of the Mini-Cog, MTS, and Medi-Cog in predicting PC.
Among 50 subjects (58% female, mean age 76.4 years), only one subject failed to pass the Mini-Cog and two failed to reach the criterion level of correctly filled PC. The mean (standard deviation) Mini-Cog score for the sample was 4.38 (0.81), MTS score was 4.1 (1.31), Medi-Cog score was 8.48 (1.82), and the mean PC was 97% (8%). The Mini-Cog and MTS individually accounted for about 30% of the variance (P < 0.001); the Medi-Cog accounted for 44% of the variance (P < 0.001), indicating strongest PC prediction.
Nearly all study participants filled pillboxes accurately. The Medi-Cog was the strongest predictor of pillbox fill accuracy. Future studies of medication self-management abilities among community-dwelling older adults should include representative samples of this population, comprehensive assessment of health status, cognitive screening, pillbox fill accuracy, and the utilization of medications in filled pillboxes.
评估社区居住的老年人药盒装药准确性及认知情况。
描述性横断面研究。
零售药店。
以60岁以上、无痴呆、服用四种以上药物且未使用过Mediset药盒的讲英语成年人为便利样本。
在面对面访谈中，受试者提供人口统计学、医疗及用药信息，完成简易认知评估（Mini-Cog）和药物认知评估（Medi-Cog，简易认知评估与药物转移筛查[MTS]的组合），并将自己的药物装入药盒。使用描述性统计和逐步回归分析进行数据分析，以正确装药数量（PC）作为因变量，认知筛查作为自变量。
Mini-Cog、MTS和Medi-Cog预测PC的准确性。
在50名受试者（58%为女性，平均年龄76.4岁）中，只有1名受试者未通过Mini-Cog测试，2名未达到正确装药的标准水平。样本的Mini-Cog平均（标准差）得分为4.38（0.81），MTS得分为4.1（1.31），Medi-Cog得分为8.48（1.82），平均PC为97%（8%）。Mini-Cog和MTS各自解释了约30%的方差（P<0.001）；Medi-Cog解释了44%的方差（P<0.001），表明其对PC的预测能力最强。
几乎所有研究参与者都能准确装药。Medi-Cog对药盒装药准确性的预测能力最强。未来关于社区居住老年人药物自我管理能力的研究应纳入该人群的代表性样本，全面评估健康状况、认知筛查、药盒装药准确性以及装入药盒的药物使用情况。
