Documentation of Functional Medication Management in Older Adults: A Retrospective Chart Review in Acute Care Hospitalization
Identifieur interne : 000382 ( Main/Curation ); précédent : 000381; suivant : 000383Documentation of Functional Medication Management in Older Adults: A Retrospective Chart Review in Acute Care Hospitalization
Auteurs : Monika Bolina ; C. Allyson Jones ; Sheri Koshman ; Erin Heintz ; Cheryl A. SadowskiSource :
- Drugs - Real World Outcomes [ 2199-1154 ] ; 2016.
Abstract
Functional skills can affect the ability of older adults to appropriately manage their medication regimens. Research evaluating a patient’s functional ability or the assessment of medication management is limited.
Our objective was to describe the documented components of functional medication management (FMM) in adults aged ≥65 years during an acute hospital stay. The secondary objective was to describe the characteristics of the healthcare providers (HCP) who document FMM.
This study was a retrospective chart review of a sample of patients aged ≥65 years admitted to medical units in a tertiary hospital from January 2013 to October 2014. FMM was defined as the steps required to take medications—including ordering, picking up, organizing, preparing, administering, and monitoring medications—and the functional abilities necessary to perform these tasks.
The mean (standard deviation [SD]) age of patients was 78.9 (8.4) years; 72 (52 %) were female. Of the 190 charts screened, 140 were eligible for inclusion. The mean (SD) number of documented scheduled oral medications was eight (3.1) per patient, and 108 (77.1 %) charts contained documented FMM-related information. Commonly documented FMM components included whether the patient could administer medications independently (73 [52 %]) or schedule medication (46 [33 %]). These activities were most frequently documented by physicians (124 [39 %]) and occupational therapists (108 [34 %]).
FMM assessments for older adult inpatients with multiple comorbidities and complex medication regimens were not documented comprehensively or frequently. Given the complexity of medication regimens and the functional skills required to manage medications at home, failing to document these assessments when evaluating patients in hospital reflects a lost opportunity.
The online version of this article (doi:10.1007/s40801-016-0092-3) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1007/s40801-016-0092-3
PubMed: 27747602
PubMed Central: 5127894
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Monika Bolina<affiliation><nlm:aff id="Aff1">Pharmacy Services, Alberta Health Services, Edmonton, AB Canada</nlm:aff>
<wicri:noCountry code="subfield">AB Canada</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="Aff2">Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB Canada</nlm:aff>
<wicri:noCountry code="subfield">AB Canada</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="Aff3">Division of Cardiology, University of Alberta, Edmonton, AB Canada</nlm:aff>
<wicri:noCountry code="subfield">AB Canada</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="Aff1">Pharmacy Services, Alberta Health Services, Edmonton, AB Canada</nlm:aff>
<wicri:noCountry code="subfield">AB Canada</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="Aff4">Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB T6G 1C9 Canada</nlm:aff>
<wicri:noCountry code="subfield">AB T6G 1C9 Canada</wicri:noCountry>
</affiliation>
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<author><name sortKey="Bolina, Monika" sort="Bolina, Monika" uniqKey="Bolina M" first="Monika" last="Bolina">Monika Bolina</name>
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<author><name sortKey="Koshman, Sheri" sort="Koshman, Sheri" uniqKey="Koshman S" first="Sheri" last="Koshman">Sheri Koshman</name>
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<author><name sortKey="Heintz, Erin" sort="Heintz, Erin" uniqKey="Heintz E" first="Erin" last="Heintz">Erin Heintz</name>
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<author><name sortKey="Sadowski, Cheryl A" sort="Sadowski, Cheryl A" uniqKey="Sadowski C" first="Cheryl A." last="Sadowski">Cheryl A. Sadowski</name>
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<series><title level="j">Drugs - Real World Outcomes</title>
<idno type="ISSN">2199-1154</idno>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Functional skills can affect the ability of older adults to appropriately manage their medication regimens. Research evaluating a patient’s functional ability or the assessment of medication management is limited.</p>
</sec>
<sec><title>Objectives</title>
<p>Our objective was to describe the documented components of functional medication management (FMM) in adults aged ≥65 years during an acute hospital stay. The secondary objective was to describe the characteristics of the healthcare providers (HCP) who document FMM.</p>
</sec>
<sec><title>Methods</title>
<p>This study was a retrospective chart review of a sample of patients aged ≥65 years admitted to medical units in a tertiary hospital from January 2013 to October 2014. FMM was defined as the steps required to take medications—including ordering, picking up, organizing, preparing, administering, and monitoring medications—and the functional abilities necessary to perform these tasks.</p>
</sec>
<sec><title>Results</title>
<p>The mean (standard deviation [SD]) age of patients was 78.9 (8.4) years; 72 (52 %) were female. Of the 190 charts screened, 140 were eligible for inclusion. The mean (SD) number of documented scheduled oral medications was eight (3.1) per patient, and 108 (77.1 %) charts contained documented FMM-related information. Commonly documented FMM components included whether the patient could administer medications independently (73 [52 %]) or schedule medication (46 [33 %]). These activities were most frequently documented by physicians (124 [39 %]) and occupational therapists (108 [34 %]).</p>
</sec>
<sec><title>Conclusion</title>
<p>FMM assessments for older adult inpatients with multiple comorbidities and complex medication regimens were not documented comprehensively or frequently. Given the complexity of medication regimens and the functional skills required to manage medications at home, failing to document these assessments when evaluating patients in hospital reflects a lost opportunity.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1007/s40801-016-0092-3) contains supplementary material, which is available to authorized users.</p>
</sec>
</div>
</front>
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