Impact of a self-administration of medications programme on elderly inpatients' competence to manage medications: a pilot study.
OBJECTIVE
Changes to medication regimens and failure to involve patients in management of their medications whilst in hospital may result in medication errors or non-adherence at home after discharge. Self-administration of medications programmes (SAMP) have been used to address this issue. The objective of this study was to assess the impact of a SAMP on elderly hospital inpatients' competence to manage medications and their medication adherence behaviours.


METHODS
The SAMP comprised three stages: education, progressing to supervised self-administration and finally to independent self-administration. Decisions to progress patients to the next level, and whether they passed or failed the SAMP, were made by the ward pharmacist and nursing staff. The Drug Regimen Unassisted Grading Scale (DRUGS) was used to assess patients' competence to manage medications at various time points. Tablet count and the Tool for Adherence Behaviour Screening (TABS) were used as adherence measures.


CONCLUSIONS
Participants (n = 24) with a mean age of 77.4 years, were mainly female and generally had a high level of functioning. They were prescribed a mean of 9.0 medications at the time of commencing the SAMP. Twenty-two of the 24 participants successfully completed the SAMP. DRUGS scores at discharge improved significantly (P<0.001) compared with that before commencement of medication self-administration. Participants reported a significant decrease (P = 0.02) in non-adherent behaviour and a trend towards improved adherent behaviour (P=0.08) after participation in the SAMP.


CONCLUSIONS
An inpatient SAMP improved elderly patients' ability to competently manage and adhere to their prescribed medications regimen. This finding needs to be confirmed in a larger controlled trial.
Southern Health Pharmacy Department, Casey Hospital, Berwick, Vic., Australia. patrick.lam@southernhealth.org.au
P
P
Lam
R A
RA
Elliott
J
J
George
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000188:drug therapy*; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D010865:Pilot Projects; D012646:Self Administration; D013647:Task Performance and Analysis; D014739:Victoria; D016903:Drug Monitoring
D004364:Pharmaceutical Preparations