Cognitive and literacy screening as predictors of ability to fill a pillbox using two pillbox assessment scoring methods.
OBJECTIVE
To compare patient cognition measured by Medi-Cog, a tool to assess cognitive literacy and pillbox skills, with pillbox concordance using two scoring methods, Pillbox Fill (PBF) and Prospective Pill Count (PPC).


METHODS
Prospective, descriptive, cross-sectional study.


METHODS
Primary care.


METHODS
Multiethnic participants with type 2 diabetes with sufficient vision and dexterity to load a pillbox.


METHODS
Medi-Cog scores were correlated with ability to fill a pillbox based on both the PPC and the PBF scoring methods. Variables were analyzed by multivariate linear and logistic regression.


METHODS
To determine whether there is a difference between PBF and PPC scoring methods relative to Medi-Cog prediction of pillbox concordance.


RESULTS
Sixty-four participants loaded an average of 5.2 medications. Mean Medi-Cog score for five patients who failed PBF but passed PPC were lower than the entire cohort (5.6 compared with 6.2). Correlation between PBF and PPC methods was 0.978; P = 0.01. Regression values for Medi-Cog's ability to predict PBF and PPC scores were r = 0.668 and r2 = 0.446, and r = 0.660 and r2 = 0.436; P < 0.01 for all.


CONCLUSIONS
Compared with PPC, PBF proved to be a more conservative scoring method and captured an additional five patients who scored less-well on the Medi-Cog. Future studies are needed to explore the value of using pillbox assessments as well as cognitive screening prior to recommending pillbox use.
Providence Health and Solutions, Seattle, Washington.
Kitty
K
Anderson
Department of Pharmaceutical Sciences, Union University School of Pharmacy, Jackson, Tennessee.
Catherine
C
Willmore
Daniel K. Inouye College of Pharmacy, University of Hawaii, Hilo.
Elizabeth
E
Doran
Daniel K. Inouye College of Pharmacy, University of Hawaii, Hilo.
Naoto
N
Oki
Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii, Hilo.
Joel
J
Vonnahme
department of pharmacotherapy, Washington State University College of Pharmacy, Spokane, Washington.
Brian J
BJ
Gates
D000328:Adult; D000368:Aged; D003071:Cognition; D003430:Cross-Sectional Studies; D005260:Female; D057220:Health Literacy; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D011446:Prospective Studies
Adherence; CDT = Clock Draw Test; Cognitive impairment; MTS = Medication Transfer Screen; Medi-Cog; Medication adherence; Medication mismanagement; Mini-Cog; PBA = Pillbox Assessment; PBF = Pillbox Fill; PPC = Prospective Pill Count; Pillbox; TIR = Three-Item Recall; r2 = Multivariate regression