Erik H. Howell|Alpana Senapati|Eileen Hsich|Eiran Z. Gorodeski
Medication self-management skills and cognitive impairment in older adults hospitalized for heart failure: A cross-sectional study
University of Rochester Medical Center|Houston Methodist|Cleveland Clinic|Cleveland Clinic
backgroundcognitive impairment highly prevalent among older adults aged 65 years hospitalized heart failure associated poor outcomes poor medication selfmanagement skills associated poor outcomes population well presence extent association cognitive impairment poor medication selfmanagement skills population clearly defined objectivewe assessed cognition consecutive older adults hospitalized heart failure relation medication selfmanagement skills methodswe conducted crosssectional study older adults aged 65 years hospitalized heart failure discharged home prior discharge assessed cognition using minicog also tested patients ability read pill bottle label open pill bottle safety cap allocate mock pills pill box pill allocation performance assessed quantitatively counts errors omission commission qualitatively patterns suggestive knowledgebased mistakes rulebased mistakes skillbased slips resultsof 55 participants 22 found cognitive impairment patients cognitive impairment tended older compared without cognitive impairment mean age 81 vs 76 years p ns patients cognitive impairment higher prevalence inability read pill bottle label prevalence ratio 58 95 confidence interval 32105 p 0001 inability open pill bottle safety cap prevalence ratio 33 95 confidence interval 1384 p 003 patients 65 pillallocation errors regardless cognition patients cognitive impairment tended errors omission mean number errors 48 vs 23 p 0006 well knowledgebased mistakes 75 vs 40 p 003 conclusionthere association cognitive impairment poor medication selfmanagement skills medication taking failures due poor medication selfmanagement skills may part pathway linking cognitive impairment poor postdischarge outcomes among patients heart failure transitioning hospital home