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A pilot study to assess cognition and pillbox fill accuracy by community-dwelling older adults
Annie Y Lam1, Kitty Anderson, Soo Borson
1Department of Pharmacy, University of Washington, Seattle, Washington.
Objective:
To assess pillbox fill accuracy and cognition among community-dwelling older adults.
Design:
A descriptive, cross-sectional study.
Setting:
Retail pharmacy.
Participants:
Convenience sample of English-speaking adults older than 60 years of age without dementia, taking more than four medications, and naive to Mediset use.
Interventions:
In face-to-face interviews, subjects provided demographic, medical, and medication information, completed the Mini-Cog and Medi-Cog (combination of Mini-Cog and medication-transfer screen [MTS]), and filled their own medications in a pillbox. Data were analyzed using descriptive statistics and stepwise regression analysis with correctly filled pill count (PC) as the dependent variable and the cognitive screens as independent variables.
Main Outcome Measures:
Accuracy of the Mini-Cog, MTS, and Medi-Cog in predicting PC.
Results:
Among 50 subjects (58% female, mean age 76.4 years), only one subject failed to pass the Mini-Cog and two failed to reach the criterion level of correctly filled PC. The mean (standard deviation) Mini-Cog score for the sample was 4.38 (0.81), MTS score was 4.1 (1.31), Medi-Cog score was 8.48 (1.82), and the mean PC was 97% (8%). The Mini-Cog and MTS individually accounted for about 30% of the variance (P < 0.001); the Medi-Cog accounted for 44% of the variance (P < 0.001), indicating strongest PC prediction.
Conclusion:
Nearly all study participants filled pillboxes accurately. The Medi-Cog was the strongest predictor of pillbox fill accuracy. Future studies of medication self-management abilities among community-dwelling older adults should include representative samples of this population, comprehensive assessment of health status, cognitive screening, pillbox fill accuracy, and the utilization of medications in filled pillboxes.
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