Validation of a Self- Administration of Medications Assessment Tool for Home Dwelling Older Adults During an Elective Admission for Rehabilitation

Background Safe medication management is challenging among older adults due to an increased prevalence of multiple chronic diseases often requiring complex multi-drug pharmacotherapy. Poly-pharmacy can increase the risk of non-adherence to medications in home dwelling older adults, reported as ranging from 6 to 55%. During hospital stays older adults may lose control over their medication management due to the shift in responsibilities from patient to healthcare professionals. Self-administration of medication (SAM) can increase patients’ understanding about their medication and promote independence and autonomy in the hospital setting. Methods From January -December 2023, all elective admissions were assessed for inclusion in SAM during their inpatient stay (n-74). An assessment tool, validated for use in the residential care setting was used. The tool, comprising of 17 items assesses the patients experience of self- medication, capability to self-medicate (cognition and function) and knowledge of their medications. Criteria for inclusion in SAM included older adults who self-administered their medication at home prior to admission and assessed as suitable using the assessment tool. Medication reconciliation was undertaken by a pharmacist for all patients prior to commencing SAM. Results 42% of admissions (n=31) were deemed suitable for SAM during their inpatient stay. Mean age 79 years (age range: 68-96 years). Number of medications > 5 medications daily. 90% (n-28) successfully completed SAM throughout their stay with 10% (n-3) reverting to nurse administration due to changes in medication during their inpatient stay Conclusion The use of the assessment tool supported a 90% success rate for SAM in this cohort. Further testing is recommended to evaluate the tool in other in-patient settings. An evaluation of SAM for the prospective of older adults and nursing team is also recommended.