2.50
Hdl Handle:
http://hdl.handle.net/10755/162622
Type:
Presentation
Title:
Medication Complexity and Knowledge of Medications in Older ED Patients
Abstract:
Medication Complexity and Knowledge of Medications in Older ED Patients
Conference Sponsor:Emergency Nurses Association
Conference Year:1999
Author:Karen, , Hayes
Contact Address:Wichita State University, 1845 Fairmount, Wichita, KS, 67260
Contact Telephone:USA
Purpose: Older patients constitute over 19% of the ED population. When discharged from the emergency department, 40% receive at least one new medication to add to their already complex medication regime. The purpose of this study was to determine the effect of increasing medication complexity on newly prescribed medication knowledge for older adults discharged from the emergency department.

Design, Setting and Sample: This correlational study was performed in three rural emergency departments. Sixty patients ranging in age from 60 to 98 participated in the study. Inclusion criteria were age 60 or greater, English speaking, triaged to urgent or deferrable category, normal mental status exam, and discharged home with one or more prescribed or recommended medication.

Methodology: Age, education level, literacy level, and self-administration medication complexity after ED treatment were measured to determine their potential influence on knowledge of medications. Medication complexity was measured by The Medication Complexity Index (MCI) which measures the number of medications, both prescription and over the counter, the number of doses per day, additional directions, and actions to administer the medications. Points are assigned for each of these areas and the sum quantifies the level of complexity. The 30 item Knowledge of Medication Subtest (KMS), an Orem based tool by Horn and Swain, assesses a person's knowledge of medication and ability to perform medication self-care. Content validity was established by three groups of experts and inter-rater reliability was established for each measurement item by staff nurses randomly assigned to measure appropriate items for selected patients. The KMS was administered by telephone interview 48 to 72 hours after ED discharge. Crobachs alpha for this study was .76.

Results: Using multiple regression, only medication complexity was a predictor of KMS, namely higher complexity being associated with worse KMS scores (r = 0.37, p = .004). Forty-five percent of the subjects (n = 27) more than doubled the complexity of their medication regime when incorporating the new medications.

Conclusions: The increase in medication complexity that results from ED therapeutic intervention requires a heightened emphasis on effective medication teaching, counseling, and written instructions for these vulnerable older patients. Follow-up telephone calls from emergency nurses could help elders clarify their medication regimen, clarify instructions, and help to correct any confusion with the discharge plan. This study focused only on older adults who are the greatest users of routine medications. Replication studies will determine whether these results are true in younger populations. [Research Paper Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleMedication Complexity and Knowledge of Medications in Older ED Patientsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162622-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Medication Complexity and Knowledge of Medications in Older ED Patients</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1999</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Karen, , Hayes</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Wichita State University, 1845 Fairmount, Wichita, KS, 67260</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">USA</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Older patients constitute over 19% of the ED population. When discharged from the emergency department, 40% receive at least one new medication to add to their already complex medication regime. The purpose of this study was to determine the effect of increasing medication complexity on newly prescribed medication knowledge for older adults discharged from the emergency department.<br/><br/>Design, Setting and Sample: This correlational study was performed in three rural emergency departments. Sixty patients ranging in age from 60 to 98 participated in the study. Inclusion criteria were age 60 or greater, English speaking, triaged to urgent or deferrable category, normal mental status exam, and discharged home with one or more prescribed or recommended medication.<br/><br/>Methodology: Age, education level, literacy level, and self-administration medication complexity after ED treatment were measured to determine their potential influence on knowledge of medications. Medication complexity was measured by The Medication Complexity Index (MCI) which measures the number of medications, both prescription and over the counter, the number of doses per day, additional directions, and actions to administer the medications. Points are assigned for each of these areas and the sum quantifies the level of complexity. The 30 item Knowledge of Medication Subtest (KMS), an Orem based tool by Horn and Swain, assesses a person's knowledge of medication and ability to perform medication self-care. Content validity was established by three groups of experts and inter-rater reliability was established for each measurement item by staff nurses randomly assigned to measure appropriate items for selected patients. The KMS was administered by telephone interview 48 to 72 hours after ED discharge. Crobachs alpha for this study was .76.<br/><br/>Results: Using multiple regression, only medication complexity was a predictor of KMS, namely higher complexity being associated with worse KMS scores (r = 0.37, p = .004). Forty-five percent of the subjects (n = 27) more than doubled the complexity of their medication regime when incorporating the new medications.<br/><br/>Conclusions: The increase in medication complexity that results from ED therapeutic intervention requires a heightened emphasis on effective medication teaching, counseling, and written instructions for these vulnerable older patients. Follow-up telephone calls from emergency nurses could help elders clarify their medication regimen, clarify instructions, and help to correct any confusion with the discharge plan. This study focused only on older adults who are the greatest users of routine medications. Replication studies will determine whether these results are true in younger populations. [Research Paper Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:31:18Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:31:18Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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