Zelfstandig beheren en gebruiken van medicijnen door ouderen in relatie tot cognitie en zelfmanagementvaardigheden

Abstract

Background: older people are responsible for managing and using their own medication at home. Drug-related problems could arise by cognitive impairment and reduced self-management abilities among community dwelling elderly. Objective: to map the manner how independent elderly living at home use and manage their medications in relation to cognition and self-management abilities.. Methods: elderly were visited at home where cognition was assessed with the clock-drawing test, self-management abilities were mapped with the Self-Management Ability Scale (SMAS-30) and the management and use of medications was mapped with an assessment of own medicationmanagement (BEM). Results: the mean age of the participants (n = 95) was 84 ± 5.7 years of age, with a mean use of 9.34 ± 2.9 medications. The mean number of answer ‘no’ to the BEM was 4.69 times (min-max 0-13). The mean totalscore of the SMAS-30 was 51.09 ± 13.7 (min-max 27.83 -94.50). High cognition was scored by 63 (66.3%) participants. Both moderate and low cognition was scored by 12 (12.6%) participants. There was a low negative correlation (rs = -0.357; p 0.000) between a lower score on the clock drawing test and a higher number of the answer ‘no’ on the BEM. There was a low negative correlation (rs = -0.473; p 0.000) between a lower score on the SMAS-30 and a higher number of the answer ‘no’ on the BEM. Conclusion: most older people in this study are able to manage their medications. Older people have moderate to good self-management abilities and little or no cognitive impairments. Cognitive impairment and reduced self-management abilities are related to a lower ability to manage and use medications. A validated instrument is needed in home health care to discover patients who needs help with their medicationmanagement. This instrument should take cognition and self-management abilities into account.