title: Documentation of Functional Medication Management in Older Adults: A Retrospective Chart Review in Acute Care Hospitalization.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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 %]).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Pharmacy Services, Alberta Health Services, Edmonton, AB, Canada.
authors.forename: Monika
authors.initials: M
authors.lastname: Bolina
authors.affiliation: Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
authors.forename: C Allyson
authors.initials: CA
authors.lastname: Jones
authors.affiliation: Division of Cardiology, University of Alberta, Edmonton, AB, Canada.
authors.forename: Sheri
authors.initials: S
authors.lastname: Koshman
authors.affiliation: Pharmacy Services, Alberta Health Services, Edmonton, AB, Canada.
authors.forename: Erin
authors.initials: E
authors.lastname: Heintz
authors.affiliation: Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, T6G 1C9, Canada. cherylas@ualberta.ca.
authors.forename: Cheryl A
authors.initials: CA
authors.lastname: Sadowski