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Consult Pharm. 2014;29(5):304-16. doi: 10.4140/TCP.n.2014.304.

Cognitive and literacy screening as predictors of ability to fill a pillbox using two pillbox assessment scoring methods.

Author information

1
Providence Health and Solutions, Seattle, Washington.
2
Department of Pharmaceutical Sciences, Union University School of Pharmacy, Jackson, Tennessee.
3
Daniel K. Inouye College of Pharmacy, University of Hawaii, Hilo.
4
Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii, Hilo.
5
department of pharmacotherapy, Washington State University College of Pharmacy, Spokane, Washington.

Abstract

OBJECTIVE:

To compare patient cognition measured by Medi-Cog, a tool to assess cognitive literacy and pillbox skills, with pillbox concordance using two scoring methods, Pillbox Fill (PBF) and Prospective Pill Count (PPC).

DESIGN:

Prospective, descriptive, cross-sectional study.

SETTING:

Primary care.

PARTICIPANTS:

Multiethnic participants with type 2 diabetes with sufficient vision and dexterity to load a pillbox.

INTERVENTION:

Medi-Cog scores were correlated with ability to fill a pillbox based on both the PPC and the PBF scoring methods. Variables were analyzed by multivariate linear and logistic regression.

MAIN OUTCOME MEASURES:

To determine whether there is a difference between PBF and PPC scoring methods relative to Medi-Cog prediction of pillbox concordance.

RESULTS:

Sixty-four participants loaded an average of 5.2 medications. Mean Medi-Cog score for five patients who failed PBF but passed PPC were lower than the entire cohort (5.6 compared with 6.2). Correlation between PBF and PPC methods was 0.978; P = 0.01. Regression values for Medi-Cog's ability to predict PBF and PPC scores were r = 0.668 and r2 = 0.446, and r = 0.660 and r2 = 0.436; P < 0.01 for all.

CONCLUSION:

Compared with PPC, PBF proved to be a more conservative scoring method and captured an additional five patients who scored less-well on the Medi-Cog. Future studies are needed to explore the value of using pillbox assessments as well as cognitive screening prior to recommending pillbox use.

KEYWORDS:

Adherence; CDT = Clock Draw Test; Cognitive impairment; MTS = Medication Transfer Screen; Medi-Cog; Medication adherence; Medication mismanagement; Mini-Cog; PBA = Pillbox Assessment; PBF = Pillbox Fill; PPC = Prospective Pill Count; Pillbox; TIR = Three-Item Recall; r2 = Multivariate regression

PMID:
24849688
DOI:
10.4140/TCP.n.2014.304
[Indexed for MEDLINE]

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