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Validation of the Medication Management Ability Assessment Tool (MMAA) for the Portuguese Older Adults

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Gerontechnology V (IWoG 2022)

Abstract

This study aimed to validate1 the Medication Management Ability Assessment (MMAA) and determine the level of functional ability of older adults to manage a simulated therapeutic regimen, understand their main limitations when facing alterations and determine the relationship between the functional ability to manage medication and cognitive function.

The adaptation was initiated with the translation and back-translation by four independent bilingual experts. The cultural dimension was developed through an external experts meeting, with a screening of concepts and constructs of the tool. The pilot study of MMAA-PT was run on a sample of 100 Portuguese community-dwelling elders. Three additional instruments were used to characterize the sample and to convergent analysis, the Mini-Mental State Examination (MMSE), the Clock Drawing Test (CDT), and the Instrumental Activities of Daily Living (IADL). Descriptive analysis, correlations, and convergent validity were conducted using Microsoft Office Excel (2022) and SPSS Statistics (v.27).

Of the 100 subjects, 70% were women, and the general mean age was 75.44 (±6.68) [65.00–94.00] years. The MMAA-PT mean score was 18.75 (±8.72) [0.00–33.00]. The convergent validity of the MMAA-PT was verified using the Spearman coefficient, with MMSE and CDT. It obtained an r-value of 0.44 in both correlations (p < 0.001), being, therefore, two significant positive correlations of moderate strength, which indicates that better scores on the MMAA-PT are associated with better cognitive function.

A European Portuguese version of the MMAA with acceptable convergent validity was obtained, which can be used in future research and clinical settings, namely in the medication reconciliation process.

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References

  1. Han, E., Sohn, H.S., Lee, J.Y., Jang, S.: Health behaviors and medication adherence in elderly patients. Am. J. Heal. Promot. 31, 278–286 (2017)

    Article  Google Scholar 

  2. Schmitt Júnior, A.A., Lindner, S., De Santa Helena, E.T.: Assessment of adherence in elderly patients in primary care. Rev. Assoc. Med. Bras. 59, 614–621 (2013)

    Article  Google Scholar 

  3. Beckman, A., Parker, M.G., Thorslund, M.: Can elderly people take their medicine? Patient Educ. Couns. 59, 186–191 (2005)

    Article  Google Scholar 

  4. Beckman, A., Bernsten, C., Parker, M.G., Thorslund, M., Fastbom, J.: The difficulty of opening medicine containers in old age: a population-based study. Pharm. World Sci. 27, 393–398 (2005)

    Article  Google Scholar 

  5. Tordoff, J., Simonsen, K., Thomson, W.M., Norris, P.T.: “It’s just routine.” A qualitative study of medicine-taking amongst older people in New Zealand. Pharm. World Sci. 32, 154–61 (2010)

    Google Scholar 

  6. Maddigan, S.L., Farris, K.B., Keating, N., Wiens, C.A., Johnson, J.A.: Predictors of older adults’ capacity for medication management in a self-medication program: a retrospective chart review. J. Aging Health 15, 332–352 (2003)

    Article  Google Scholar 

  7. Tordoff, J.M., Bagge, M.L., Gray, A.R., Campbell, A.J., Norris, P.T.: Medicine-taking practices in community-dwelling people aged ≥75 years in New Zealand. Age Ageing 39, 574–580 (2010)

    Article  Google Scholar 

  8. Cross, A., Elliott, R., Petrie, K., Kuruvilla, L., George, J.: Interventions for improving medication-taking ability and adherence in older adults prescribed multiple medications (Review). Cochrane Database Syst. Rev. 1–227 (2020)

    Google Scholar 

  9. Patton, D.E., Hughes, C.M., Cadogan, C.A., Ryan, C.A.: Theory-based interventions to improve medication adherence in older adults prescribed polypharmacy: a systematic review. Drugs Aging 34, 97–113 (2017)

    Article  Google Scholar 

  10. Elliott, R.A., Marriott, J.L.: Standardised assessment of patients’ capacity to manage medications: a systematic review of published instruments. BMC Geriatr. 9, 1–10 (2009)

    Article  Google Scholar 

  11. Edelberg, H.K., Shallenberger, E., Wei, J.Y.: Medication Management capacity in highly functioning community-living older adults: detection of early deficits. J. Am. Geriatr. Soc. 47, 592–596 (1999)

    Article  Google Scholar 

  12. Advinha, A.M., Henriques, A., Guerreiro, M.P., Nunes, C., Lopes, M.J., Oliveira-Martins, S.: Cross-cultural validation of the Drug Regimen Unassisted Grading Scale (DRUGS) to assess community-dwelling elderly’s ability to manage medication. Eur. Geriatr. Med. 7, 424–429 (2016)

    Article  Google Scholar 

  13. Patterson, T.L., Lacro, J., McKibbin, C.L., Moscona, S., Hughs, T., Jeste, D.V.: Medication management ability assessment: results from a performance-based measure in older outpatients with schizophrenia. 22, 11–19 (2002)

    Google Scholar 

  14. World Health Organization. Medication Without Harm-Global Patient Safety Challenge on Medication Safety. WHO 1–16 (2017)

    Google Scholar 

  15. World Health Organization. Medication Safety in Transitions of Care. Technical Report. WHO 52 (2019)

    Google Scholar 

  16. Mansur, N., Weiss, A., Hoffman, A., Gruenewald, T., Belooseky, Y.: Continuity and adherence to long-term drug treatment by geriatric patients after hospital discharge. A prospective cohort study. Drugs Aging 25, 861–870 (2008)

    Google Scholar 

  17. Arevalo-Rodriguez, I., Smailagic, N., Roqué-Figuls, M., Ciapponi, A., Sanchez-Perez, E., Giannakou, A., et al.: Mini-Mental State Examination (MMSE) for the early detection of dementia in people with mild cognitive impairment (MCI). Cochrane Database Syst. Rev. 2021 (2021)

    Google Scholar 

  18. Sumida, C.A., Vo, T.T., Van Etten, E.J., Schmitter-Edgecombe, M.: Medication management performance and associated cognitive correlates in healthy older adults and older adults with aMCI. Arch. Clin. Neuropsychol. 34, 290–300 (2019)

    Article  Google Scholar 

  19. Folstein, M., Folstein, S., Mchugh, P.: Mini-mental state" A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res. 12, 189–198 (1975)

    Article  Google Scholar 

  20. Freedman, M., Leach, L., Kaplan, E., Winocur, G., Shulman, K.I., Delis, D.C.: Clock Drawing: A Neuropsychological Analysis. Oxford University Press, Oxford (1994)

    Google Scholar 

  21. Tuokko, H., Hadjistavropoulos, T., Miller, J.A., Beattie, B.L.: The Clock Test: a sensitive measure to differentiate normal elderly from those with Alzheimer disease. J. Age Relat. Disord. 40, 579–584 (1992)

    Google Scholar 

  22. Atalaia-Silva, K.C., Lourenço, R.A.: Translation, adaptation, and construct validation of the Clock Test among elderly in Brazil. Rev Saúde Pública 1–7 (2008)

    Google Scholar 

  23. Botelho, M.A.: Autonomia funcional em idosos - Caracterização multidimensional em idosos utentes de um centro de saúde urbano. 1–237 (1999)

    Google Scholar 

  24. Lawton, M.P., Broody, E.M.: Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 179–186 (1969)

    Google Scholar 

  25. Sousa, V.D., Rojjanasrirat, W.: Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: a clear and user-friendly guideline. J. Eval. Clin. Pract. 17, 268–274 (2011)

    Article  Google Scholar 

  26. Streiner, D.L., Norman, G.R.: Health Measurement Scales: A Practical Guide to their Development and Use. Oxford University Press, Oxford (2008)

    Book  Google Scholar 

  27. Nunnally, J.C., Bernstein, I.H.: Psychometric Theory. McGraw-Hill, New York (1994)

    Google Scholar 

  28. Advinha, A.M., Nunes, C., de Barros, C.T., Lopes, M.J., Oliveira-Martins, S.: Key factors of the functional ability of older people to self-manage medications. Sci. Rep. 11, 1–9 (2021)

    Article  Google Scholar 

  29. International Pharmaceutical Federation (FIP). Medicines reconciliation: A toolkit for pharmacists. The Hague: International Pharmaceutical Federation (2021)

    Google Scholar 

  30. Redmond, P., Grimes, T.C., McDonnell, R., Boland, F., Hughes, C., Fahey, T.: Impact of medication reconciliation for improving transitions of care. Cochrane Database Syst. Rev. 8 (2018)

    Google Scholar 

  31. National Institute for Health and Care Excellence (NICE). Medicines optimisation: the safe and effective use of medicines to enable the best possible outcomes (2015). https://www.nice.org.uk/guidance/ng5

  32. The Joint Commission. National Patient Safety Goals (2022). https://www.jointcommission.org/standards/national-patient-safety-goals/

  33. Advinha, A.M., Lopes, M.J., de Oliveira-Martins, S.: Assessment of the elderly’s functional ability to manage their medication: a systematic literature review. Int. J. Clin. Pharm. 39(1), 1–15 (2016). https://doi.org/10.1007/s11096-016-0409-z

    Article  Google Scholar 

  34. Gellad, W.F., Grenard, J.L., Marcum, Z.A.: A systematic review of barriers to medication adherence in the elderly: looking beyond cost and regimen complexity. Am. J. Geriatr. Pharmacother. 9, 11–23 (2011)

    Article  Google Scholar 

Download references

Acknowledgments

Special acknowledgments are given to Professor Carla Teixeira de Barros (University of Lisbon, Faculty of Pharmacy), Professor Adriana Henriques (University of Lisbon, School of Nursing), and Professor Mara Pereira Guerreiro (Instituto Superior de Ciências da Saúde Egas Moniz. In memoriam to Professor Carla Nunes (National School of Public Health, NOVA Lisboa).

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Correspondence to Ana Margarida Advinha .

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Advinha, A.M. et al. (2023). Validation of the Medication Management Ability Assessment Tool (MMAA) for the Portuguese Older Adults. In: Moguel, E., de Pinho, L.G., Fonseca, C. (eds) Gerontechnology V. IWoG 2022. Lecture Notes in Bioengineering. Springer, Cham. https://doi.org/10.1007/978-3-031-29067-1_39

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  • DOI: https://doi.org/10.1007/978-3-031-29067-1_39

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