# Medication Adherence Functional Capacity in the Aging Population: Development of an Ecologically Validated Assessment

> **NIH NIH R36** · WASHINGTON STATE UNIVERSITY · 2020 · $68,787

## Abstract

The aging population is the largest consumer base of prescribed medications, with 40% of older adults
managing 5 or more drugs. However, approximately 50% of these prescribed medications are not taken as
directed. Repercussions from nonadherence in the aging population include an annual $100 to $289 billion
dollars in health care costs, inaccurate efficacy results for clinical drug trials and significant public health issues
like increased rates of comorbid diseases and anti-biotic resistance. The long-term objective of this project is to
build a quick, reliable and ecological valid clinical assessment to capture cognitive-related nonadherence risk
and to develop tailored interventions to reduce nonadherence. The primary objective of this application is to
test four medication adherence components hypothesized to be contributors of cognitive-related medication
nonadherence in older adults and, therefore, necessary for inclusion in such a clinical assessment of
functioning (i.e., performance-based measure). Building on my prior work, the approach will be to examine
relationships between real-world adherence and performance-based measures of medication knowledge,
management, prospective memory and compensatory strategy problem-solving abilities (Aims 1-3). In
addition, the proposed research will demonstrate how each performance-based measure independently
captures aspects of real-world medication adherence above and beyond known neuropsychological correlates
(Aim 1-3). Finally, performance-based measures that best predict real-world medication adherence will be
identified by using hierarchical regressions to analyze the relationships between the performance-based
measures and real-world medication adherence (Aim 4). A quick ecologically valid assessment for cognitive-
related nonadherence is expected to provide the research and clinical community a tool to identify medication
nonadherence risk. The approach is innovative because it will (a) monitor and measure medication adherence
using the participant’s everyday medication devices (i.e., using Estimotes, thin attachable movement sensors);
(b) examine the relationship between medication performance-based measures and real-world adherence; and
(c) utilize novel medication performance-based measures to examine abilities thought to be critical to
supporting real-world adherence (i.e., prospective memory and compensatory strategy problem-solving,
unexamined aspects of medication adherence). A measure of medication functional capacity is significant
because it extends medication nonadherence measurements beyond self-reports and captures real-world
cognitive-related medication nonadherence risk. Therefore, this measure has the potential to aid in diagnostic
decision making and identifying specific medication functional deficits that could be targeted with
interventions. Given the significant burden of cognitive-related medication nonadherence, this measure is
expected to have a downstream impact on reduc...

## Key facts

- **NIH application ID:** 9979547
- **Project number:** 1R36AG064278-01A1
- **Recipient organization:** WASHINGTON STATE UNIVERSITY
- **Principal Investigator:** Catherine Sumida
- **Activity code:** R36 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $68,787
- **Award type:** 1
- **Project period:** 2020-05-15 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9979547

## Citation

> US National Institutes of Health, RePORTER application 9979547, Medication Adherence Functional Capacity in the Aging Population: Development of an Ecologically Validated Assessment (1R36AG064278-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9979547. Licensed CC0.

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