Assessing self-administration of medication: video-based evaluation of patient performance in the ABLYMED study
BackgroundOlder adults often face challenges in medication management due to multimorbidity and complex medication regimens, which frequently go unreported. Unrecognized problems, however, may lead to a loss of drug efficacy and harmful side effects. This study aimed to quantify the prevalence of su...
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Frontiers Media S.A.
2024-11-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2024.1444567/full |
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| author | Anneke Luegering Robert Langner Robert Langner Stefan Wilm Thorsten R. Doeppner Thorsten R. Doeppner Thorsten R. Doeppner Thorsten R. Doeppner Dirk M. Hermann Helmut Frohnhofen Helmut Frohnhofen Janine Gronewold |
| author_facet | Anneke Luegering Robert Langner Robert Langner Stefan Wilm Thorsten R. Doeppner Thorsten R. Doeppner Thorsten R. Doeppner Thorsten R. Doeppner Dirk M. Hermann Helmut Frohnhofen Helmut Frohnhofen Janine Gronewold |
| author_sort | Anneke Luegering |
| collection | DOAJ |
| description | BackgroundOlder adults often face challenges in medication management due to multimorbidity and complex medication regimens, which frequently go unreported. Unrecognized problems, however, may lead to a loss of drug efficacy and harmful side effects. This study aimed to quantify the prevalence of such problems by applying a novel video-based assessment procedure in a sample of elderly patients.MethodsIn this study, 67 elderly in-patients (≥70 years old and regularly taking ≥5 different drugs autonomously) from the ABLYMED study participated in a placebo-based assessment of medication management with five different dosage forms in an instructed manner while being filmed. Patient performance was quantified by the median value of two raters who evaluated each step of medication administration, which were summed to sum scores for each dosage form and an overall impression for each dosage form with a standardized and previously validated rating scheme.ResultsThe median (Q1;Q3) sum score for tablets was 7.0 (5.0;8.0) with a theoretical range between 4.0 and 17.0, for eye-drops 2.0 (1.0;2.0) with a theoretical range between 1.0 and 5.0, for oral drops 4.0 (3.0;6.0) with a theoretical range between 3.0 and 12.0, for pens 7.0 (5.0;9.0) with a theoretical range between 4.0 and 17.0 and for patches 5.0 (4.0;7.0) with a theoretical range between 3.0 and 15.0. The most difficult step of medication administration was peeling off the protective liner of a patch: 30% had severe difficulties or it was not possible, 21% had moderate difficulties and 49% had mild or no difficulties.DiscussionIn a sample of patients with autonomous medication management, our novel assessment procedure identified a substantial fraction of patients with handling problems for each dosage form. This suggests that patients´ medication management problems should be assessed regularly in clinical routine and tackled by patient-individual training or modification of the prescribed drug regimens to achieve effective drug therapy in the elderly. |
| format | Article |
| id | doaj-art-1e2bbd1198b44a2a9123a93a9c7ac7b5 |
| institution | Kabale University |
| issn | 2296-858X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj-art-1e2bbd1198b44a2a9123a93a9c7ac7b52024-11-19T14:14:26ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2024-11-011110.3389/fmed.2024.14445671444567Assessing self-administration of medication: video-based evaluation of patient performance in the ABLYMED studyAnneke Luegering0Robert Langner1Robert Langner2Stefan Wilm3Thorsten R. Doeppner4Thorsten R. Doeppner5Thorsten R. Doeppner6Thorsten R. Doeppner7Dirk M. Hermann8Helmut Frohnhofen9Helmut Frohnhofen10Janine Gronewold11Hospital Pharmacy, University Hospital Düsseldorf, Düsseldorf, GermanyInstitute of Systems Neuroscience, University Hospital Düsseldorf, Düsseldorf, GermanyInstitute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, GermanyInstitute of General Practice, Centre for Health and Society (chs), University Hospital Düsseldorf, Düsseldorf, GermanyDepartment of Neurology, University Hospital Giessen, Giessen, GermanyResearch Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University, Istanbul, TürkiyeDepartment of Anatomy and Cell Biology, Medical University of Varna, Varna, BulgariaDepartment of Neurology, University of Göttingen, Göttingen, GermanyDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS) University Hospital Essen, University Duisburg-Essen, Essen, Germany0Department of Orthopedics and Trauma Surgery, University Hospital Düsseldorf, Düsseldorf, Germany1Department of Medicine, Geriatrics, Faculty of Health, Witten, GermanyDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS) University Hospital Essen, University Duisburg-Essen, Essen, GermanyBackgroundOlder adults often face challenges in medication management due to multimorbidity and complex medication regimens, which frequently go unreported. Unrecognized problems, however, may lead to a loss of drug efficacy and harmful side effects. This study aimed to quantify the prevalence of such problems by applying a novel video-based assessment procedure in a sample of elderly patients.MethodsIn this study, 67 elderly in-patients (≥70 years old and regularly taking ≥5 different drugs autonomously) from the ABLYMED study participated in a placebo-based assessment of medication management with five different dosage forms in an instructed manner while being filmed. Patient performance was quantified by the median value of two raters who evaluated each step of medication administration, which were summed to sum scores for each dosage form and an overall impression for each dosage form with a standardized and previously validated rating scheme.ResultsThe median (Q1;Q3) sum score for tablets was 7.0 (5.0;8.0) with a theoretical range between 4.0 and 17.0, for eye-drops 2.0 (1.0;2.0) with a theoretical range between 1.0 and 5.0, for oral drops 4.0 (3.0;6.0) with a theoretical range between 3.0 and 12.0, for pens 7.0 (5.0;9.0) with a theoretical range between 4.0 and 17.0 and for patches 5.0 (4.0;7.0) with a theoretical range between 3.0 and 15.0. The most difficult step of medication administration was peeling off the protective liner of a patch: 30% had severe difficulties or it was not possible, 21% had moderate difficulties and 49% had mild or no difficulties.DiscussionIn a sample of patients with autonomous medication management, our novel assessment procedure identified a substantial fraction of patients with handling problems for each dosage form. This suggests that patients´ medication management problems should be assessed regularly in clinical routine and tackled by patient-individual training or modification of the prescribed drug regimens to achieve effective drug therapy in the elderly.https://www.frontiersin.org/articles/10.3389/fmed.2024.1444567/fullself-administrationagedmedication management problemsvideo recordingsadministration steps |
| spellingShingle | Anneke Luegering Robert Langner Robert Langner Stefan Wilm Thorsten R. Doeppner Thorsten R. Doeppner Thorsten R. Doeppner Thorsten R. Doeppner Dirk M. Hermann Helmut Frohnhofen Helmut Frohnhofen Janine Gronewold Assessing self-administration of medication: video-based evaluation of patient performance in the ABLYMED study Frontiers in Medicine self-administration aged medication management problems video recordings administration steps |
| title | Assessing self-administration of medication: video-based evaluation of patient performance in the ABLYMED study |
| title_full | Assessing self-administration of medication: video-based evaluation of patient performance in the ABLYMED study |
| title_fullStr | Assessing self-administration of medication: video-based evaluation of patient performance in the ABLYMED study |
| title_full_unstemmed | Assessing self-administration of medication: video-based evaluation of patient performance in the ABLYMED study |
| title_short | Assessing self-administration of medication: video-based evaluation of patient performance in the ABLYMED study |
| title_sort | assessing self administration of medication video based evaluation of patient performance in the ablymed study |
| topic | self-administration aged medication management problems video recordings administration steps |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2024.1444567/full |
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