Objective: An important aspect of inpatient Polytrauma rehabilitation is the accurate assessment of a patient's ability to perform Independent Activities of Daily Living (IADL), such as managing prescription medications. In the inpatient rehabilitation setting, nursing staff assess medication management skill through observation of graduated levels of responsibility over time. Although there are no published formal methodologies for assessing medication management skill, the observation method is considered best practice. The purpose of the current project was to evaluate the utility of the Pillbox Test as an objective measure to predict ability to manage medication. Method: Eight patients (mean age = 36) in a VA Polytrauma Transitional Rehabilitation Program were administered the Pillbox Test (Zartman et al., 2013). This is a simulated medication management task which requires accurate placement of five “medications” with different administration schedules, into a weekly pillbox. A passing score required a complete pillbox with no omission, commission, or misplacement errors. Test data were compared to the patient's Self Medication Program level (SMP), a three-tiered classification system for level of independence with medication management. Results: The Pillbox Test was passed by 100% of patients (n = 4) at SMP 3 (Independent management), while 75% of the patients (n = 3) at SMP ≤2 failed. One patient at SMP ≤2 passed the Pillbox Test. Conclusion: The findings provide initial support for the use of the Pillbox Test to evaluate inpatient capacity for independent medication management. Longitudinal research on this measure may further help to elucidate its clinical utility in need for assistance with prescription management at home following discharge.
Utility of The Pillbox Test in an Inpatient Polytrauma Rehabilitation Setting
J Sordahl, E Critchfield, K McCoy, E Halmai; A-88
Utility of The Pillbox Test in an Inpatient Polytrauma Rehabilitation Setting. Arch Clin Neuropsychol 2015; 30 (6): 519. doi: 10.1093/arclin/acv047.88
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