The "Medication Matters ... To You!" educational intervention session: A pilot study to improve medication management in community-living older adults
Older adults are highly susceptible to the effects of inadequate health literacy (HL). Independently-living elders comprise most of this population, and are at risk for medication misuse. Grounded in integrated HL theory, a pre-experimental, pre- and posttest study was pilot-tested with participants living in an independent-living retirement facility to determine whether a brief, low-HL tailored intervention on common medication management issues could effect immediate changes in the dependent variables of knowledge and self-efficacy (SE). Baseline HL status was evaluated using the Newest Vital Sign (NVS) tool. Nonparametric analyses were utilized to assess relationships due to the small sample size (N=14). Higher SE pre-test scores correlated with higher SE post-test scores (p = .784,p = .001). Pre-test knowledge scores strongly correlated with baseline HL scores (p = .646,p = .012). 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. Likert-type scale assessment of participant satisfaction was not related to baseline HL status. Qualitative satisfaction assessment revealed positive themes four times as often as negative themes. Positive themes centered on the type of content, its utility and comprehensibility. Among negative themes, dislike of the NVS was strong. Results showed the intervention more than doubled knowledge scores in 100% of participants. However, SE scores were not significantly changed, pointing to need for long-term follow-up. Follow-up is also necessary to ascertain knowledge retention for long-term outcome evaluation. While the NVS is cognitively challenging for this sample population, the current study indicates its ability to identify high performers on HL knowledge assessments, lends credence to reports that it discriminates between limited/not limited HL subpopulations, and adds to the knowledge base concerning its use. These results help to elucidate effective practice strategies for improved medication management in geriatric HL interventions, and aid in evaluating HL's role in mediating public health efforts.