Pilot testing of a brief pre-consultation medicines adherence tool in a geriatric outpatient setting

In older adults, medication non-adherence is prevalent and harmful. Current methods of identification have limitations, with direct questioning often being met with a reluctance to 'admit' non-adherence to healthcare professionals. The Making Medicines Work for You (MMWFY) tool consists of seven items (mapped to recognised adherence barriers) and a free-text box, and has been developed to support patients and clinicians identify and discuss adherence issues in a clinical setting. This study piloted the tool in a geriatric outpatient population.

Patients attending the Older Person' Assessment Unit at a London teaching hospital completed the MMWFY tool. Descriptive analysis was used to determine the incidence and type of potential adherence barriers. Associations and correlations between the tool and existing measures of adherence (MARS-5) and medicines beliefs (BMQ) were assessed.

Of 245 patients approached, 226 consented to participate: 120 (53.1%) males; mean age 78 years. On the MMWFY, 115 (50.9%) participants selected at least one item (median 1, range 0-5), indicating the presence of a potential adherence barrier. 'I've found my own way to use my medicines' (n = 53, 27.5%) and 'I sometimes forget to take my medicines' (n = 45, 23.3%) were the most frequently selected. The tool demonstrated association and correlation with validated adherence measures.

Half of the participants reported potential barriers to medication adherence. The high rate of completion and association with existing adherence measures suggest that the tool may have value in this setting. Further work is required to explore the barriers identified and how to use these to develop appropriate adherence support.