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Awareness and Implementation of the Age-Friendly 4Ms Framework: A Needs Assessment Survey
Yu-Hua Fu1,2, Jing Wu3, Barbara Zarowitz1,2
1Department of Practice, Sciences, and Health Outcomes Research, University of Maryland Baltimore School of Pharmacy, Baltimore, Maryland, USA.
Journal of the American Geriatrics Society
|August 29, 2025
Summary
Pharmacists show awareness of the Age-Friendly Health Systems (AFHS) initiative's 4Ms but lack comfort in assessing "Mobility" and "Mentation." Targeted education is needed to improve comprehensive geriatric care.
Area of Science:
- Geriatric Pharmacy
- Health Systems Science
- Interprofessional Education
Background:
- The Age-Friendly Health Systems (AFHS) initiative promotes high-quality care for older adults using the 4Ms: "What Matters," "Medication," "Mentation," and "Mobility."
- Pharmacists are crucial in interprofessional teams for implementing the 4Ms, yet their familiarity and comfort with this framework are not well-understood.
Purpose of the Study:
- To assess the awareness and comfort levels of pharmacists, specifically American Society of Consultant Pharmacists (ASCP) members, regarding the 4Ms framework.
- To identify specific areas within the 4Ms where pharmacists may require additional training and support.
Main Methods:
- A needs assessment survey was administered to ASCP members, comprising 38 items across participant characteristics, AFHS initiative familiarity, and 4Ms comfort.
- Comfort was measured using a five-point Likert scale; scores of 4-5 indicated comfort, while 1-3 indicated less comfort.
- Respondents were considered comfortable with a 4M domain if they scored 4 or 5 on all related items.
Main Results:
- Of 232 respondents, 62.1% were aware of the AFHS initiative, but only 20% reported facility-level involvement.
- Pharmacist comfort varied significantly across the 4Ms: "Medication" (73.3%), "What Matters" (71.1%), "Mobility" (28.9%), and "Mentation" (27.2%).
- A substantial number of pharmacists reported never assessing "Mobility" (61.2%) or "Mentation" domains (e.g., dementia 53.0%).
Conclusions:
- Pharmacists demonstrate a need for enhanced education and training, particularly in assessing "Mobility" and "Mentation" in older adults.
- Improving pharmacists' skills in medication optimization and integrating the 4Ms cohesively are essential for person-centered geriatric care.
- Targeted interventions are required to increase pharmacist confidence and competence in applying the full spectrum of the 4Ms framework.
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