Irvine-Meek Janice, Gould Odette N, Wheaton Hannah, Todd Laura E
, BSc(Pharm), PharmD, FCSHP, is with Pharmacy Services, Zone 1, Moncton, Horizon Health Network, New Brunswick.
Can J Hosp Pharm. 2010 May;63(3):225-32. doi: 10.4212/cjhp.v63i3.918.
A majority of community-dwelling older adults manage their own medication regimens. This study describes the development and first phase of testing of the Self-Medication Assessment Tool (SMAT), designed to screen for cognitive and functional deficits in relation to medication self-management among community-dwelling geriatric patients.
To evaluate the face validity of the SMAT and to determine its acceptability among pharmacists.
An instrument was designed, with 5 assessment scales to measure function, cognition, medication recall, and 2 aspects of adherence. The instrument included a standardized test kit and instructions for testers. Focus groups interviews, individual interviews, and surveys were used to determine the reactions of community and hospital-based pharmacists to the tool. Transcripts of the focus group and individual interviews were coded for main themes. Pharmacists' ratings of usefulness, thoroughness, and ease of use, as well as their willingness to use the instrument, were compared with a neutral rating on a 7-point scale by means of 1-sample t tests.
Focus group interviews or individual interviews were conducted with 17 pharmacists and 3 pharmacy students (out of a potential population of about 300) who responded to an invitation to participate. The pharmacists felt that the tool would be useful in identifying difficulties with medication management and potential interventions, and they expressed a willingness to use it in their respective practices. Pharmacists working in hospital settings were slightly more willing than community pharmacists to use the tool. Interviewees highlighted ways to improve the tool before testing of its psychometric properties in the planned second phase of this project.
The SMAT had strong face validity and was particularly acceptable for use by pharmacists in hospital settings.
大多数居家的老年人自行管理自己的用药方案。本研究描述了自我用药评估工具（SMAT）的开发及测试的第一阶段，该工具旨在筛查居家老年患者在用药自我管理方面的认知和功能缺陷。
评估SMAT的表面效度，并确定其在药剂师中的可接受性。
设计了一种工具，包含5个评估量表，用于测量功能、认知、药物记忆以及依从性的两个方面。该工具包括一个标准化测试套件和给测试人员的说明。采用焦点小组访谈、个人访谈和调查来确定社区和医院药剂师对该工具的反应。对焦点小组和个人访谈的记录进行编码以找出主要主题。通过单样本t检验，将药剂师对工具的有用性、全面性和易用性的评分，以及他们使用该工具的意愿，与7分制的中性评分进行比较。
对17名药剂师和3名药学专业学生（约300人的潜在群体中的一部分）进行了焦点小组访谈或个人访谈，他们回应了参与邀请。药剂师们认为该工具在识别用药管理困难和潜在干预措施方面会很有用，并且他们表示愿意在各自的工作中使用它。在医院工作的药剂师比社区药剂师更愿意使用该工具。受访者强调了在该项目计划的第二阶段对工具进行心理测量特性测试之前改进该工具的方法。
SMAT具有很强的表面效度，尤其在医院环境中，药剂师对其接受度较高。
