Table 1 Study characteristics

Advinha AM., et al., [29] 2021

Portugal

Drug Regimen Unassisted Grading Scale (DRUGS)

Self-Medication Assessment Tool

(SMAT)

Observational study

(Cross sectional)

To assess the ability of older people to self-manage their medication.

Community-dwelling residents over 65 years old

207

75.5 years

Female (75.4%)

Male (24.6%)

The probability that an older individual would be able to manage medications with total accuracy (100%) increases exponentially with cognitive competence. The functional ability of older people to self-manage medications was found to be clearly associated with cognitive impairment.

Caffery DM., et al., [30]2007

US

Cognitive Screen for Medication

Self-Management (CSMS) Test in Older Adults

Validity study

To evaluate specific identified psychometric properties of the CSMS.

Community dwelling individuals age from 72 to 95 and living independently

60

NR

Female (75%)

Male (25%)

Established validity for cognitive status and age, Reliability measure, Internal consistency, -0.08-0.84.

Insel, K., et al., [31]

2006

US

Mini-Mental State

Examination (MMSE)

Wisconsin Card Sorting Test (WCST)

Digit Span Backward (DSB)

California Verbal

Learning Test (CVLT)

Observational study (cohort study)

To investigate the association between cognitive processes and medication adherence

among community-dwelling older adults.

Older adults

(67 years or older)

100

78 years

Female (78%)

Male (22%)

Executive function and working memory tasks were the only significant predictor (b = .44, p < .01) of medication adherence. Assessments of executive function and working memory can be used to identify community-dwelling older adults who may be at risk for failure to take medicines as prescribed.

Kripalani, S., et al., [32]

2006

US

Drug Regimen Unassisted Grading Scale (DRUGS)

Rapid Estimate of

Adult Literacy in Medicine (REALM)

Observational study (Cross sectional study)

To evaluate the effects of low literacy, medication regimen complexity, and sociodemographic characteristics on MMC.

Patients with CHD

435

65.4 years

Female (54.6%)

Male (45.4%)

Total DRUGS scores increased with literacy level (P=.001), as did the ability to identify medications correctly (P< .001). Patients with inadequate literacy specifically struggled with identifying their medications by viewing the bottle exterior or label (P< .001, compared with higher literacy patients).

Lam, AY., et al., [33]

2011

US

Mini-Cog

Medi-Cog

Medication-Transfer screen (MTS)

Observational study (Cross sectional study)

To assess pillbox, fill accuracy and cognition

among community-dwelling older adults.

Community-dwelling older adults > 60 years of age,

50

76.4 years

Female (58%)

Male (42%)

All components of the cognitive screens except the clock draw portion of the Mini-Cog were significantly associated with PC. The Mini-Cog and MTS individually accounted for about 30% of the variance (P < 0.001); their combination into the Medi-Cog was the strongest predictor of PC, accounting for 44% of the variance (P < 0.001). Medi-Cog was the strongest predictor of PC.

Lubinga, SJ., et al., [34]

2011

UK

Self-Medication Risk Assessment Tool (RAT)

Observational study (Cross sectional study)

To determine scale reliability and validate the instrument against community pharmacists'

assessment of patients' ability to manage their medicines.

Older adults who were at least 65 years old

37

Median

age-76years

Female (48.6%)

Male (51.4%)

Cronbach’s alphas were 0.792, 0.679 and 0.813 for the 13-item, cognitive risk, and the physical risk sub-scales respectively. The total risk score and cognitive risk sub-scores were significantly worse among multi-compartment compliance aid users compared to the non-users.

Mortelmans, L., et al., [35] 2021

Belgium

Medication Management Instrument for Deficiencies in the Elderly (MedMaIDE)

Observational study (Cross sectional study

To describe post-discharge medication self-management by geriatric patients with polypharmacy, to describe the problems encountered and to determine the related factors.

Older adults aged least 75 years old, used five or more prescribed medicines.

400

82 years

Female (52.5%)

Male (47.5%)

After discharge, 70% did fully self-manage their medication, 27% received help with preparing their medication but self-administered their medicines and 3% received help with preparing and administering medicines at home. Approximately 90% of patients experienced at least one medication management deficiency after discharge. Most deficiencies were related to medication knowledge (mean 3.1 [SD 1.8]).

Kim, JS., et al., [36]

2013

South Korea

Mini-Mental State Examination (MMSE)

Montreal Cognitive Assessment (MoCA)

Observational study (Cross sectional study

To evaluate the correlation

between ability to manage medication and

cognitive functioning in patients with PD.

PD patients

208

66.4 years

Female (55.29%)

Male (44.71%)

Correlations between PillQ scores and scores on the MMSE and MoCA approached moderate strength. Among the MMSE subscales, orientation (-0.403 p<0.001) and memory registration (-0.314 p<0.001) were most strongly related to scores on the PillQ. The orientation (-0.363 p<0.001) and visuospatial subscales (-0.375 p<0.001) of the MoCA were strongly correlated with PillQ scores.

Anderson, RE., et al., [37]

2016

US

Short Blessed Test (SBT)

Montreal Cognitive

Assessment (MoCA)

Trail-Making Test (TMT)

Observational study (prospective)

To determine whether cognitive dysfunction, in particular impaired executive function, may be a risk factor for early readmission in older adults independently managing their medications.

Individuals aged 65 and older

452

74.7 years

Female (59.1%)

Male (40.9%)

For participants managing medications themselves, adjusted 30-day odds of readmission increased 13%

on average with each point decrease in SBT score (P = .003) and 9% on average with each 0.01 decrease in TMT-B score (P = .02).

Risser, J., et al., [38]

2007

US

Self-Efficacy for Appropriate Medication Use Scale (SEAMS)

Rapid Estimate of Adult Literacy in Medicine (REALM)

Experimental study

To develop a self-efficacy scale for medication adherence in chronic disease management that can be used in patients with a broad range of literacy skills.

Patients with documented coronary heart disease (CHD) who presented to the clinic

436

63.8 years

Female (55.7%)

Male (44.3 %)

The final 13-item scale had good internal consistency reliability (Cronbach’s α 0.89). Test-retest reliability of the 21-item scale was moderate (Spearman’s ρ 0.62, p 0.0001). Self-efficacy as measured by the scale was strongly correlated with medication adherence as assessed by the Morisky scale (Spearman’s ρ 0.51, p .0001).

Castel-Branco, M., et al., [39] 2015

Portugal

Mini-Mental State Examination (MMSE)

Observational study (Cross sectional study

To identify the elements required for an appropriate

medication self-management in elderly in order to create a Good Practice Guideline for home visits to isolated polypharmacy elderly.

Patients with 65 or more years old, living alone

34

NR

NR

From a total of 37 seniors, only 62 % were considered non-adherents although 87 % knew when to take their medication, and 85 % reported using different memory strategies, such as associating the administration with a specific activity, pillboxes, or the location of the medicine at home.

Marks, TS., et al., [40] 2020

US

Mini-Cog

Medi-Cog-R

Medication-transfer screen-revised (MTS-R)

Observational study (Cross sectional study

To examine whether a combined cognitive and performance-based medication management measure would be able to better classify an individual’s functional cognitive status and potential for instrumental activities of daily living (IADL) impairment than either measure alone.

Community-dwelling adults

185

70.68 years

Female (76.2%)

Male (23.8 %)

The Mini-Cog, the MTS-R, and the Medi-Cog-R all show discriminant validity, but the combined measure demonstrates greater sensitivity and specificity than either component measure alone in identifying IADL impairment.

O'Conor, R., et al., [41]

2019

US

Short Test of Functional Health Literacy in Adults

(S-TOFHLA)

Trail Making Test (TMT)

Mini Mental State

Exam (MMSE)

Observation study (cohort study)

To assess the association between health literacy and cognitive abilities with self -management behaviors in patients

with COPD.

Adults with COPD

388

68 years

Female (58.3%)

Male (41.7 %)

Compared with individuals with adequate health literacy, participants with limited health literacy were less likely to be adherent to their COPD medicines (23.3% vs. 46.0%, p < 0.001), demonstrate correct MDI (57.8% vs. 71.9%, p = 0.02) or DPI (40.0% vs. 56.7%, p = 0.04) technique, or have one healthcare provider regularly manage their COPD. Global cognitive ability was predictive of correct MDI and

DPI technique.

Son, YJ., et al., [42]

2017

South Korea

Self‐Efficacy for Appropriate Medication Use Scale

(SEAMS)

Observational study (Cross sectional study

To examine the mediating role of self‐efficacy in the relationship between depression and medication adherence among older patients with hypertension.

Older adults patients with hypertension

255

73.89 years

Female (48.2%)

Male (51.8%)

Depression was significantly negatively correlated with self‐efficacy (r = −.26, P < .001) and medication adherence (r = −.24, P < .001), while self‐efficacy was significantly positively correlated with medication adherence (r = .53, P < .001), depression significantly predicted self‐efficacy (β = .20, P = .002) and medication adherence (β = −.28, P < .001).

Wajda, B., et al., [43]

2014

US

National Eye Institute Visual Function Questionnaire-25

(NEI VFQ–25)

Observational study (Cross sectional study-prospective)

To determine whether personality traits influence self-reported functional vision in patients with age-related macular degeneration (AMD).

Patients with

AMD

182

84.1 years

Male (29%)

Female (71%)

For near functional vision, visual acuity [95%

confidence interval {CI} 0.46, 0.20]; p 0.001), and education [95% CI 0.01, 0.15]; p 0.03) were statistically significant predictors. For distance functional vision, only visual

acuity [95% CI – 0.69, – 0.29]; p 0.001) was statistically significant predictor.

Yang, C., et al., [44]

2021

China

Medication-Specific Social Support

Questionnaire (MSSS)

The Self-Efficacy for Appropriate Medication Use Scale

(SEAMS)

Protocol for a randomised controlled trial

To implement an evidence-based, theory-informed, and nurse-led medication self-management intervention among older patients with multimorbidity and examine its effects in community settings.

Community-dwelling older patients with multimorbidity.

NR

NR

NR

NR

Smith, SG., et al., [45]

2015

US

The Rapid Estimate of

Adult Learning in Medicine (REALM)

Test of Functional Health Literacy in Adults

(TOFHLA-R)

The Newest Vital Sign (NVS)

Comprehensive Health Activities Scale (CHAS)

Observational study (Cross sectional study

To investigate the relationship between literacy and numeracy and their association with health task performance.

English-speaking adults ages 55 to 74

304

63.2 years

Female (74.7%)

Male (25.3%)

Literacy and numeracy were both significantly associated with performance on all tasks (literacy range, b = 0.23–0.45, all ps < 0.001; numeracy range, b = 0.31– 0.41, all ps < 0.001).

Curtis, LM., et al., [46]

2016

US

The Rapid Estimate of

Adult Learning in Medicine (REALM)

Test of Functional Health Literacy in Adults

(TOFHLA-R)

The Newest Vital Sign (NVS)

Comprehensive Health Activities Scale (CHAS)

Observational study (Cross sectional study)

To determine the prevalence of various forms of cognitive decline over a 3-year period, and to examine associations with requisite health literacy and self-management skills.

English-speaking adults ages 55 to 74

545

66 years

Female (69%)

Male (31%)

Decline in long term memory was associated with poorer self-management skills (beta -3.26, 95%CI -4.96, -1.55; p < 0.001). Cognitive decline was not associated with performance on the REALM or the NVS assessments.

Sluggett, JK., et al., [15]

2020

Australia

Drug

Regimen Unassisted Grading Scale (DRUGS)

Self-Efficacy for Appropriate Medication use Scale

(SEAMS)

Non-randomized pilot and feasibility study

To determine the feasibility of a multi-component intervention to simplify medication regimens for people receiving community-based home care services.

Older adults

25

79 years

Female (64%)

Male (36%)

The DRUGS assessment showed most participants were able to self-manage their medications, participants who received intervention did so with a high degree of protocol adherence and acceptability.

Simplification was possible for 14 participants (56%) and implemented for 7 (50%) at follow-up.

Beckman, A., et al., [47]

2005

Sweden

Mini-Mental State Examination (MMSE)

Observational study (Cross sectional study)

To investigate elderly people’s ability to open medicine containers, and how this ability correlates to some common disorders that may cause functional or cognitive impairment.

Older adults aged 75 years or older,

604

86.7 years

Male (22.4%)

Female (77.6%)

14% were unable to open a screw cap bottle, 32% a bottle with a snap lid, and 10% a blister pack. Female gender, higher age, living in an institution, Parkinson’s disease, rheumatoid arthritis, cognitive impairment and impaired vision were all associated with a decreased ability to open the containers.

Somerville, E., et al., [20]

2019

US

HOME–Rx-revised

Medication Management Instrument for Deficiencies in the Elderly

(MedMaIDE)

Medication Management

subscale of the Performance Assessment of Self-care Skills (PASS)

Observational study (Cross sectional study)

To further develop the HOME–Rx, an in-home medication management assessment, by modifying scoring metrics, improving clinical utility, and establishing psychometric properties.

Older adults

Phase 1: 4 Phase2:30

Phase1-73.8 years

Phase2-75.8 years

Phase1-

Female (50%)

Male (50%)

Phase2-

Female (73.3%)

Male (26.7%)

Phase 1- Administration time was reduced from an average of 65 to 75 min to 25 to 35 min.

Phase2: The PASS was positively correlated with the HOME–Rx Performance and Safety subscales; the MedMaIDE was negatively correlated with the HOME–Rx Performance subscale and positively correlated with the Barriers subscale. Interrater reliability was excellent (ICCs = .87–1.00).

Murphy, MC., et al., [48]

2017

US

In-Home Medication Performance Evaluation (HOME–Rx)

Validity study

To develop a novel, performance-based medication adherence assessment.

Older adult

12

Content expert participants 7

Older adult 5

75.6 years

Female (60%)

Male (40%)

Content experts were in agreement that the overall instrument was valid for measuring

medication management (scale-level CVI 5 .95). Older adult participants reported the instrument was relevant, acceptable, and easy to understand.

Hutchison, LC., et al., [49]

2006

US

Medication Management Ability Assessment (MMAA)

Drug

Regimen Unassisted Grading Scale (DRUGS)

Mini-Mental State Examination (MMSE)

Observational study (Cross sectional study)

To compare the Medication Management Ability Assessment (MMAA) and the Drug Regimen Unassisted Grading Scale (DRUGS) as standardized tools to assess medication management skills in elderly patients with a range of cognitive function.

Individuals with

Alzheimer's disease and a control group

52

75.8 years

Female (69%)

Male (31%)

The 49 participants who took the MMAA had a mean (SD) score of 19.4 (6.1), with a range of 0 to 25. The 46 participants who took the DRUGS had a mean (SD) score of 91.6 (24.7), with

a range of 0 to 100.The MMAA and the DRUGS correlated with one another (P = 0.000).

Miller, DJ., et al., [50]

2022

US

The National Eye Institute Visual Function

Questionnaire (NEI-VFQ-25)

Functional Health Literacy Scale (FHL)

Pilot study

Prospective, single-arm pilot study with a pre post design.

To investigate whether demographic, clinical, or psychosocial factors act as moderators of change in medication adherence in the Support, Educate, empower (SEE) program.

Glaucoma patients

39

63.9 years

Female (44%)

Male (56%)

There were no significant differences in the slopes of adherence for better-eye MD, visual acuity, number of comorbidities, visual function measured by the NEI-VFQ-25 score, FHL or GMSE in response to medication reminders (P > 0.05) for all comparisons.

Advinha, AM., et al., [22]

2016

Portugal

Self-Medication Assessment Tool

(SMAT)

Pilot study

To assess elderly’s medication management ability using the Self Medication Assessment Tool – Portuguese Version (SMAT-PT) and to correlate the performance between standard and real therapeutic regimens.

Portuguese community-dwelling elders

150

74.73 years

Female (74.7%)

Male (25.3%)

The SMAT-PT standard regimen mean scores were 20.92 (±6.83) in functional ability and 38.75 (±5.92) in cognitive ability. Significant correlations between medication recall and standard regimen items were found. Cognitive measures were directly correlated with medication management ability.

Alosco, ML., et al., [51]

2012

US

Mini Mental State Examination (MMSE)

Trail Making Test (TMT)

Observational study (Retrospective observational analyses)

To examine whether cognitive functioning predicts instrumental ADL performance in persons with HF.

HF population

122

68.49 years

Female (35.2%)

Male (64.8%)

In each case, poorer neuropsychological test performance was associated with poorer instrumental ADL function. Poorer cognitive test basic performance was associated with reduced independence in medication management

Bailey, S., et al., [52]

2015

US

Measure of Drug Self-Management (MeDS)

Observational study (Cross sectional study)

To develop and evaluate a comprehensive yet brief Measure of Drug Self-Management (MeDS) for use in research and clinical settings among diverse patient groups.

Diagnoses of diabetes and hypertension

193

61.1 years

Female (60.1%)

Male (39.9%)

MeDS demonstrated adequate internal consistency with a Cronbach’s α of 0.72.

The scale was significantly correlated with the Morisky Medication Adherence Scale (r= -0.62; P,0.001), low-density lipoprotein cholesterol (r= -0.27, P<0.001) and diastolic blood pressure (r= -0.18, P=0.01).

McCann, RM., et al., [16]

2012

Australia

Daily Living Tasks

associated with Vision (DLTV)

Observational study (case–control study)

To compare issues relating to medication self-management between older people with and without VI.

Individuals aged ≥65 years,

Visually impaired-156, Control-158

Visually impaired-81 years

Control-77.8 years

Visually impaired-

Male (35.9%) Female (64.1%)

Control-\

Male-(38.6 %) Female -(61.4 %)

Significantly more with VI (29%), compared to controls (13%) (OR = 2.8 [95% CI = 1.6 to 5.0]; age-adjusted OR = 2.6 [95% CI = 1.4 to 4.7]) relied on help to take their medication each day or to sort it into a compliance aid (a container holding usually seven daily aliquots of medication, each within separate sections).

Raehl, CL., et al., [53]

2002

US

Med Take test

Whisper test

Mini-Mental State Examination (MMSE)

Observational study (Cross sectional study)

To quantify how seniors’ ability to take oral prescription drugs safely may correlate with age, sex, socioeconomic status, education, cognitive impairment, depression, and drug self-management.

Older adults

57

79.49 years

Female (72%)

Male (28%)

Significant predictors of the outcome MedTake test score, adjusted for age and sex, were MMSE (b = 0.393, p=0.002) and Medicaid assistance in last 10 years (b = -0.302, p=0.021).

Creech, CL., et al., [54]

2016

US

Self-Efficacy for Appropriate Medication use Scale (SEAMS)

Newest Vital Sign (NVS)

Pilot study

To determine whether a brief, low-HL tailored intervention on common medication management issues could affect immediate changes in the dependent variables of knowledge and self-efficacy (SE).

Independently living older adults

(Greater than 65 years)

14

84.06 years

Female

(92.8 %)

Male

(7.2 %)

Post-test knowledge scores were significantly higher than pre-test scores for all participants (M = 8.43, Mdn = 9.00, SD =1.651 versus M = 3.93, Mdn = 4.00, SD = 1.817; p < .001). Change in knowledge and SE scores were not related to age, educational attainment, or baseline HL status.

Chin, J., et al., [55]

2021

US

Rapid Estimate of Adult Literacy in Medicine (REALM)

Observational study (Cross sectional study)

To examine how health literacy and its components (processing capacity and knowledge about illness) influence memory for medication purposes.

Individuals with diagnosis of type II diabetes mellitus

674

63.6 years

Female (55.2%)

Male (44.8 %)

Health literacy was associated with memory for medication purposes, with processing capacity and health knowledge partly mediating this association. (F (5,665) = 18.97, p < .001, adjusted R2 = 0.12, SE = 0.94).

Sumida, CA. [56],et al.,

2019

US

Medication Management Ability Assessment

(MMAA)

Observational study (Cross sectional study)

To examine the performance of healthy older adults’ (HOA) and individuals with amnestic mild cognitive impairment (aMCI) on the medication management abilities assessment’s original scoring criteria and derived error process measures.

Healthy older adults and individuals with amnestic mild cognitive impairment (aMCI)

50

Healthy older adults-25

Individuals with aMCI- 25

HOAs- 70.68

aMCI- 70.80

HOAs- Female-(68%)

Male (32%)

aMCI- Female (80%)

Male (20%)

Individuals with aMCI performed more poorly than HOAs on the MMAA score and process error measures. The aMCI group showed significantly poorer performance on measures of total overtaking error (η2 = .169), total undertaking error (η2 = .099), the magnitude error score (η2 = .291) and the MMAA score (η2 = .258).

Thuy LT., et al., [57]

2020

Thailand

Multidimensional Scale of Perceived Social Support (MSPSS)

Short Test of Functional Health Literacy in Adults

(S-TOFHLA)

Observational study (Cross sectional study)

To examine the factors of medication regimen complexity, physical function, social support, health literacy, patient-provider communication, health belief, and self-efficacy in explaining

medication adherence of older people with hypertension.

Individuals aged

60 years or older; being diagnosed with HTN and

undertaking antihypertensive drug for at least 6 months;

300

68.11 years

Female (42%)

Male (58%)

Five variables (medication regimen complexity, health literacy, patient-provider communication, health belief, and self-efficacy) were significantly associated with medication

adherence. Physical function and social support were not significantly related to medication adherence (-.136*, -.114*).

Windham, BG., et al., [58]

2005

UK

Hopkins Medication Schedule

(HMS)

Pelli-Robson letter sensitivity chart (PR test)

Randot Circles (stereovision)

Early Treatment Diabetic Retinopathy Study eye chart (ETDRS)

Observational study (Cross sectional study)

To assess relationships between vision (Contrast sensitivity, stereopsis, visual acuity) and a performance-based measure of ability to implement new medications.

Community-dwelling women aged 70 to 80 years

335

76.8 years

only female

Each vision measure was positively associated with Pillbox Ratio scores and varied with cognition and time to completion. Better visual acuity, contrast sensitivity, and stereopsis were each associated with better performance in women with poor cognition who filled the pillbox quickly.

Robnett, RH., et al., [59]

2007

US

ManageMed Screening (MMS)

Hopkins Medication Schedule(HMS)

Observational study (Cross sectional study)

To introduce ManageMed and complete initial reliability and validity analyses on the

ManageMed Screening.

Volunteer participants, aged

65 and over.

67

76 years

NR

Adequate reliability and concurrent validity were established. Internal consistency,

Cronbach’s Alpha of 0.89 (42 items). Interrater reliability on individual questions ranging from 0.859 to 0.965. A moderate correlation was attained between ManageMed total score and the total Cognistat score (0.696, p = 0.01), indicating that the results for both tests are similar (concurrent validity).

Russell, AM., et al., [60]

2018

UK

Rapid Estimate of Adult Literacy in Medicine (REALM)

Observational study (Cross sectional study)

To explores patient preferences for functionality in a smartphone application (app) that supports medication self-management among older adults with multiple chronic conditions.

English-speaking older adults (55 and older) who owned

smartphones and took five or more prescription medicines

46

65 years

Female-70%

Male-30%

Desired features included (1) a list and consolidated schedule of medications, (2)

identification and warning of unsafe medication interactions, (3) reminder alerts to take medicine, and (4) the ability record when medications were taken.

Irvine-Meek, J., et al., [61]

2010

Canada

Self-Medication Assessment Tool (SMAT)

Observational study (Cross sectional study)

To evaluate the face validity of the SMAT and to determine its acceptability among pharmacists.

Pharmacists and pharmacy students

20

NR

NR

Participants rating the SMAT; 70% (14/20) for usefulness, 35% (7/20) for ease of use, 60% (12/20) for thoroughness, and 55% (11/20) for willingness to use. Pharmacists and pharmacy students working in hospital settings were more willing to use the SMAT than those working in community settings (p = 0.08, effect size = 0.17).

Haus, CS., et al., [14]

2003

US

Mini-Mental State Exam (MMSE)

Martin and Park Environmental

Demands Questionnaire (MPED)

Long-Term Medication Behavior Self-Efficacy Scale (LTMBSES)

Perceived

Social Support from Friends (PSS-Fr) and the Perceived Social Support

from Family (PSS-Fa)

Observational study

non-experimental descriptive-correlational research design

To describe factors and medication strategies used by community dwelling elderly persons who live alone.

Older adults living alone

60

77.4 years

Females (90%)

Males (10%)

No significant association was found between the outcome and the 7 predictor variables (MMSE, GDS-S, SS-Fa, SS-Fr, MSE, MPED-routine, MPED-busyness) (Wilks’ lambda is .822 (x2 = 10.637; p = .154))

Visscher BB., et al., [62]

2020

Netherland

Functional, Communicative and Critical Health Literacy scales (FCCHL)

Observational study Two-phase qualitative study

To explore the needs of people with low health literacy and DM2 regarding medication self-management and to explore the preferences for medication self-management support.

People with DM2 and low health literacy

18

NR

Female- (39%)

Male- (61%)

The participants preferred to be supported with reliable and easily understandable Information, adequate interactive communication with health care professionals and fellow people with diabetes and tools for medication self-management support.

Klymko , KW., et al., [63]

2008

US

Fuld Object-Memory Evaluation (FOME)

Pilot study

To examine the prevalence of selected cognitive impairments and explore the relationships among cognitive function, hypertension related self-care, and blood pressure in African American older adults.

African American men and women aged 60 and older

39

70 years

Female (69%)

Male (31%)

46% African American elders had a high prevalence of cognitive impairments. A strong positive association was found between cognition(memory) and HTN related self-care (correct medication use) (r=0.59 p<0.05).

Westerbotn, M., et al., [64]

2008

Sweden

Mini-Mental State Examination (MMSE)

Descriptive study

To describe how older people living at home experienced the management of their own medication regimen from their own perspective.

Individuals aged ≥85 years, living at home

25

89.8 years

Female (64%)

Male (36%)

Most participants managed their medicines by themselves and were very content with this. Most important components for older people were to have good cognitive ability, to be independent and to get support with their medicines from a close person as a backup.

Deupree JP, et al., [65]

2011

UK

Test of Functional Health Literacy in Adults

(TOFHLA-R)

Medication Administration Self-Efficacy Scale (MASES)

Mixed method study

To explore how community dwelling adults ages 60 to 74 self-manage five or more daily prescription medications.

Community dwelling older adult

15

71.27 years

Female (87%)

Male (13%)

Regardless of the health literacy level or the number of daily prescribed medications, participants demonstrated high accuracy of self-management for their medications.

Kapoor A., et al., [66]

2018

UK

Show back

Observational study (Cross sectional study)

To develop and test a comprehensive simulation which assesses older

adult medication self-management proficiency.

English-speaking individuals aged 65+

9

76 years

NR

Inter-rater agreement- high proficiency

across all five domains (83%–100%).