Development of the Medication Adherence Skills Assessment – Verbal Strategy Subtask

Catherine Sumida

doi:10.7273/000005111

Introduction: Important medication adherence skills include strategies to support remembering to take medication or prospective memory (PM), remembering what medications were taken or retrospective memory (RM), and organizing medications into a dose regimen or dose efficiency (DE). However, no measure assesses these important strategy skills. To fill this gap, the current study developed the Medication Adherence Skills Assessment – Verbal Strategy subtask. Method: Forty-two older adults participated in this three-testing session tele-health study. Participants were presented seven different hypothetical medication regimen scenarios (MRS) for which they verbally provided different strategies and their medication regimen plan. Their responses were coded into PM and RM strategies as well as a DE score (i.e., how much they combined medication doses together). Participants also completed a battery of cognitive and self-report measures, including self-reported measures assessing PM, RM, executive functioning and personal medication strategies. Results: Inter-rater reliability was above .90 for the RM, PM and DE variable. Cronbach’s alphas were .90 for PM, .91 for RM and .69 for DE. Low correlations were found between PM, RM and DE variables. Divergent validity was demonstrated by low correlations with self-reported mobility and semantic fluency measures. For convergent validity, participant’s PM and RM scores related to self-reported everyday medication strategies. The DE variable did not relate to any hypothesized cognitive or self-reported cognitive problems or medication strategies. However, an interesting pattern was observed where participants tended to prioritize PM strategies, especially routine reminders, rather than using a simpler dose regimen (DE). Discussion: Preliminary inter-rater and internal consistency reliability and construct validity were demonstrated for PM and RM. Only inter-rater reliability was demonstrated for DE at this time. The sample’s characteristics, which may have contributed to variability in developing a dose regimen and influenced DE’s internal consistency and validity are discussed. Currently, no medication strategy development measure exists. This study’s coding methods and results may provide researchers with tools in understanding some older adult approaches to medication strategy development for PM, RM and DE. Although additional research is needed, observed trade-offs between routine reminders and DE may have future clinical implications in medication strategy development between patient and medical teams.

Development of the Medication Adherence Skills Assessment – Verbal Strategy Subtask

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