PT  - JOURNAL ARTICLE
AU  - Roseleen M McCann
AU  - A Jonathan Jackson
AU  - Michael Stevenson
AU  - Martin Dempster
AU  - James C McElnay
AU  - Margaret E Cupples
TI  - Help needed in medication self-management for people with visual impairment: case–control study
AID  - 10.3399/bjgp12X653570
DP  - 2012 Aug 01
TA  - British Journal of General Practice
PG  - e530--e537
VI  - 62
IP  - 601
4099  - http://bjgp.org/content/62/601/e530.short
4100  - http://bjgp.org/content/62/601/e530.full
SO  - Br J Gen Pract2012 Aug 01; 62
AB  - Background Visual impairment (VI) is rising in prevalence and contributing to increasing morbidity, particularly among older people. Understanding patients’ problems is fundamental to achieving optimal health outcomes but little is known about how VI impacts on self-management of medication.Aim To compare issues relating to medication self-management between older people with and without VI.Design and setting Case–control study with participants aged ≥65 years, prescribed at least two long-term oral medications daily, living within the community.Method The study recruited 156 patients with VI (best corrected visual acuity [BCVA] 6/18 to 3/60) at low-vision clinics; community optometrists identified 158 controls (BCVA 6/9 or better). Researchers visited participants in their homes, administered two validated questionnaires to assess medication adherence (Morisky; Medication Adherence Report Scale [MARS]), and asked questions about medication self-management, beliefs, and support.Results Approximately half of the participants in both groups reported perfect adherence on both questionnaires (52.5% Morisky; 43.3%, MARS). Despite using optical aids, few (3%) with VI could read medication information clearly; 24% had difficulty distinguishing different tablets. More people with VI (29%) than controls (13%) (odds ratio [OR] = 2.8; 95% confidence interval [CI] = 1.6 to 5.0) needed help managing their medication, from friends (19% versus 10%) or pharmacists (10% versus 2.5%; OR = 4.4, 95% CI = 1.4 to 13.5); more received social service support (OR = 7.1; 95% CI = 3.9 to 12.9).Conclusion Compared to their peers without VI, older people with VI are more than twice as likely to need help in managing medication. In clinical practice in primary care, patients’ needs for practical support in taking prescribed treatment must be recognised. Strategies for effective medication self-management should be explored.