Factors Related to Medication Self-Management in African American Older Women.
Julie L Ellis, Christine R Kovach, Michael Fendrich and 4 others
PMID 30893443WHAT IT FOUND
Medication self-management was low among 116 African American older women.
Age, confidence with medicines, and medicines fitting daily goals were linked to better self-management. Medical mistrust, caregiving strain, and a medication side-effect risk score were not.
Key findings
01Medication self-management was low: mean Morisky score 5.46 on a 0.25 to 8 scale, where 5 is considered low.
02Age, how well medications fit personal goals, and confidence with medications were significant predictors together; goal congruence was strongest, followed by self-efficacy and age, and they explained approximately 30% of the variation in medication self-management.
03Medical mistrust, caregiver role strain, and anticholinergic burden were not significantly correlated with medication self-management scores.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The participants were recruited from a convenience sample in one central-city area of Milwaukee, so the results may not apply to other communities or to African American women outside that setting. The study was cross-sectional, so it can show associations but cannot show that changing goal congruence or self-efficacy would improve medication self-management. Medication self-management and many exposures were self-reported, so memory and social desirability could affect the answers. The pharmacy list covered prescription medications only; over-the-counter drugs and supplements were self-reported and may have been missed. The Morisky scale had low reliability and measured only part of medication self-management. The goal congruence tool was newly modified and may not distinguish between having no medication goal and having no problem meeting a goal. Most participants were in their 60s, and the sample did not reflect much older adult care. Caregiver role strain was unexpectedly low, so the study may not capture the effect of high caregiving responsibilities.
Declared interests
No author conflict-of-interest statement appears in the supplied text. The paper is tagged as supported by NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not read this as proof that helping patients fit medications to their goals will improve medication self-management. The study is correlational and used a convenience sample, so it cannot show cause.