Self-reported understanding of diabetes and its treatment among elderly ambulatory subjects in British Columbia.
BACKGROUND
There is little published information on the level of self-reported understanding of diabetes mellitus (DM) and its treatment among elderly subjects with DM or on the association between such understanding and the likelihood of errors in the recall of medication regimens.


OBJECTIVE
The primary objectives of the present study were to describe self-reported understanding of DM and its treatment among elderly subjects with DM, and to determine whether poorer understanding of the disease and its treatment was predictive of medication-recall errors. Secondary objectives were to assess the potential association of certain demographic and disease-specific variables with subjects' understanding of DM and its treatment.


METHODS
This was a cross-sectional survey of elderly subjects (age > or =65 years) with DM who were taking oral hypoglycemic medications and/or insulin and were seen at an outpatient DM clinic in British Columbia. The study questionnaire, which was administered at the clinic, included questions on self-reported understanding of DM and its treatment, sources of disease and drug information, and subjects' specific medication regimens. Subjects' reports of their medication regimens (medication, dose, directions for administration) were reconciled against information in the provincial prescription drug database. A medication-recall error was defined as a discrepancy between the self-reported medication name (including failure to mention a medication), dose, or frequency of administration and the record in the database. Medication-recall errors were used as a proxy for the likelihood of making an error that could lead to actual medication-related harm.


RESULTS
Forty-nine subjects (25 men, 24 women; mean [SD] age, 76.1 [6.3] years) were enrolled in the study. The majority (59.2%) of subjects reported having an above average understanding of DM, and 36.7% reported having an above average understanding of DM treatment. When subjects' reported diabetic medication regimens were checked against the provincial prescription database, 12 subjects had not accurately recalled at least 1 aspect of their regimen: 6 cases involved incorrect recall of the dose, 4 involved inability to state the medication name, and 2 involved omitting to mention a medication. Among the 12 subjects with medication-recall errors, 10 (83.3%) reported having an above average understanding of DM, and 7 (58.3%) reported having an above average understanding of DM treatment.


CONCLUSIONS
In this cohort, despite a high self-reported understanding of DM and its treatment, 24.5% of subjects made at least 1 error in accurately recalling their medication regimen.
Villanyi
Diane
D
Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Wong
Roger Y M
RY
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001955:British Columbia; D032882:Comprehension; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000188:drug therapy*; D005260:Female; D005544:Forecasting; D015577:Geriatric Assessment; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008508:Medication Errors; D011939:Mental Recall; D010353:Patient Education as Topic; D012646:Self Administration
D007004:Hypoglycemic Agents