Awareness and Implementation of the Age-Friendly 4Ms Framework: A Needs Assessment Survey

The Age-Friendly Health Systems (AFHS) initiative, focusing on the 4Ms-"What Matters," "Medication," "Mentation," and "Mobility," aims to provide high quality care to adults aged 65 and older. Pharmacists are well-positioned to champion the 4Ms within collaborative, interprofessional care teams. Yet, little is known about pharmacists' awareness of and comfort with the 4Ms.

A needs assessment survey was distributed to American Society of Consultant Pharmacists members to evaluate their familiarity with the 4Ms framework and comfort in assessing and acting on the 4Ms. The survey included 38 items across three sections: participant characteristics, familiarity with AFHS initiative, and comfort with the 4Ms. Comfort was rated on a five-point Likert scale, with scores of 4-5 categorized as comfortable and 1-3 as not/less comfortable. Participants were considered comfortable with a specific 4M domain if they scored 4 or 5 on all related items.

The survey had a view rate of 11.3% and a viewer participation rate of 58.3%. Of 232 respondents, 44.0% chose consultant pharmacist for their primary professional role, and 51.7% practiced in post-acute, long-term, and residential care settings. Most (62.1%) respondents were aware of the AFHS initiative, but just 20% reported facility-level involvement. Comfort in assessing each of the 4Ms varied: "Medication" (73.3%), "What Matters" (71.1%), "Mobility" (28.9%) and "Mentation" (27.2%). Only 17.7% of respondents were comfortable assessing the set of 4Ms. Although 81% of respondents routinely assessed high-risk medications, 71.6% were confident in deprescribing them. A sizable percentage had never assessed "Mobility" (61.2%) or "Mentation" (46.5% for depression; 53.0% for dementia).

Findings underscore the need for targeted education and training to enhance pharmacists' comfort in assessing "Mobility" and "Mentation," improve skills in medication optimization, and promote integration of the set of 4Ms as a cohesive approach to person-centered care.