PROJECT SUMMARY/ABSTRACT
In order to maintain independence into late adulthood, one must be able to safely and reliably participate in
Instrumental Activities of Daily Living (IADLs), including taking medications for treatment of chronic conditions.
The potential to do this safely without making a medication error depends on a multitude of pre-conditions,
including: the number of distinct medications consumed, cognitive status (e.g., dementia), the presence of a
caregiver or other mental scaffolds (i.e., medication diary), and cognitive vulnerability (e.g., susceptibility to
distraction). Medication errors are numerous — over a million yearly injuries and 98,000 deaths — and occur
across the spectrum of healthcare (i.e., nurses, physicians, pharmacists, patients), yet little is known about
medication errors in daily life. For this R03, we are specifically interested in understanding the types of
medication errors made in daily life, and discovering person-specific and situation-specific risk factors for
medication errors in the home. Perceptions of medication administration problems, medication regimen
complexity, and the nature of medication errors in the home and their consequences will be assessed in older
adults currently recruited into the Einstein Aging Study (EAS), using an innovative three-pronged medication
assessment (i.e., daily EMA of medication administration problems, medication error history interview with study
neurologist, medication possession ratios from EHRs). Making use of existing clinical data (i.e., ratings of MCI),
and cognitive performance data (both in-lab and ambulatory assessments) we will identify person-specific and
situation-specific risk factors for various types of medication errors. Completion of this work will highlight
actionable targets for future interventions targeting the reduction of medication errors.