Assessing Geriatric Patients’ Ability to Functionally Manage Medication Packaging
Bibliographic record
Abstract
ABSTRACT Background: Various studies have recommended that a skills assessment for safe medication management be incorporated into routine evaluation of geriatric patients. It has previously been demonstrated that pharmacists are more likely than other health care professionals to discover obstacles to self-administration of medication among older patients and to undertake interventions to ameliorate these barriers. Objectives: To identify the proportion of geriatric hospital patients with functional inability to manipulate medication packaging and to determine any specific patient characteristics that might be used to predict this problem. Methods: For this prospective, nonrandomized, observational study, 60 consenting geriatric patients were asked to perform a variety of timed tasks related to medication management. Results: One-third of the patients in this study demonstrated overall impairment of ability to functionally manage medication packaging. Many of the patients were unable to distinguish different pill colours (25 or 42%) or to open and remove tablets from a non-child-resistant container (17 or 28%) or a blister pack (7 or 12%). Individual risk factors could not be identified, although those who demonstrated impaired functional ability were somewhat older (85.8 years versus 81.7 years, p = 0.003). The average time spent by the pharmacist to conduct the skills assessment exceeded 30 min. Conclusion: Many of the geriatric inpatients in this study had impairment of their ability to perform specific function-related tasks in a simple and straightforward screening tool. However, the ideal screening tool to assess medication management skills among older people, incorporating the functional and cognitive components of these tasks and suitable for administration by any member of the health care team, has not yet been identified. RESUME Historique : Diverses etudes ont recommande qu’une evaluation de l’aptitude des patients âges pour la manipulation securitaire des medicaments soit incorporee a leur evaluation de routine. Il a deja ete demontre que les pharmaciens sont plus susceptibles que d’autres professionnels de la sante de decouvrir les obstacles a l’auto-administration des medicaments chez les patients âges et de prendre les mesures necessaires pour lever le plus possible ces obstacles. Objectifs : Determiner la proportion de patients âges hospitalises qui presentent des incapacites fonctionnelles les empechant de manipuler les emballages de medicaments et determiner les caracteristiques particulieres de ces patients qui pourraient servir a predire ce probleme. Methodes : Dans le cadre de cette etude d’observation prospective non randomisee, 60 patients âges ont ete selectionnes et on leur a demande d’executer diverses tâches minutees relatives a la manipulation des medicaments. Resultats : Le tiers des patients de cette etude presentaient une incapacite fonctionnelle generale a manipuler les emballages de medicaments. Un grand nombre de ces patients etaient incapables de distinguer les differentes couleurs des comprimes (25 ou 42 %) ou d’ouvrir et de prendre des comprimes d’un contenant sans fermeture de protection a l’epreuve des enfants (17 ou 28 %) ou d’une plaquette alveolee (7 ou 12 %). Les facteurs de risque individuels n’ont pas pu etre determines, bien que les patients qui presentaient une incapacite fonctionnelle etaient un peu plus âges (85,8 ans contre 81,7 ans, p = 0,003). Les pharmaciens ont passe en moyenne plus de 30 minutes a evaluer ces aptitudes. Conclusion : Plusieurs de ces patients âges hospitalises presentaient une incapacite fonctionnelle dans leur aptitude a executer des tâches specifiques, lors d’un test d’aptitude simple administre par le pharmacien. Toutefois, il a ete impossible de determiner le test ideal pour evaluer les aptitudes a la manipulation des medicaments chez les personnes âgees, qui englobe a la fois les aspects fonctionnels et cognitifs des tâches evaluees et peut etre administre par n’importe quel membre de l’equipe de soins de sante.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".