{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:50:06Z","timestamp":1791615006184,"version":"4.3.4"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003579","name":"University of Toronto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003579","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"publisher"}]},{"name":"KRESCENT"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People on hemodialysis experience high rates of cognitive impairment and are prescribed complex medication regimens, increasing their risk of medication errors. Although hemodialysis units are convenient settings for medication education, it is unclear whether patients can effectively learn a new regimen during a hemodialysis session.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a secondary analysis of multicenter, cross-sectional data from Toronto, Canada. One hundred one\u00a0participants completed the Medication Management Ability Assessment (MMAA), Montreal Cognitive Assessment (MoCA), and Lawton-Brody Instrumental Activities of Daily Living (IADL) scale during the first hour of a hemodialysis session. We calculated the proportion of participants who scored as impaired on the MMAA (\u226427), examined predictors of impairment, and calculated correlations between the MMAA, MoCA, and the medication management item from the Lawton-Brody IADL scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 353 patients screened, 101 were eligible and completed all assessments (mean age 67 years; 29% female; median dialysis vintage 36 months). Fifty-five participants (54%; 95% confidence interval [CI]: 44\u201364%) were impaired on the MMAA, including 23 who reported being independent with medication management in daily life. MMAA scores correlated moderately with the MoCA (r = 0.585, P &amp;lt; 0.001) and were significantly associated with self-reported dependence on the Lawton-Brody medication item (\u03c72(1, n = 101) = 20.00, P &amp;lt; 0.001). Older age (adjusted odds ratio [OR] = 1.08, 95% CI [1.03, 1.12], P &amp;lt; 0.001) and racialized status (adjusted OR = 3.53, 95% CI [1.23, 10.07], P = 0.019) were significantly associated with impaired MMAA performance in a multivariable logistic regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Over half of participants had difficulty learning a new medication regimen during a hemodialysis session. Findings highlight the need to reconsider when and how medication education is delivered to this population, and to develop interventions that support their learning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/joneph\/aajag099","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T11:42:49Z","timestamp":1778845369000},"page":"1230-1237","source":"Crossref","is-referenced-by-count":0,"title":["Assessing Patients\u2019 ability to learn medication protocols during a hemodialysis session"],"prefix":"10.1093","volume":"39","author":[{"given":"Urooj","family":"Khan","sequence":"first","affiliation":[{"name":"Rehabilitation Sciences Institute, University of Toronto , Toronto ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shlomit","family":"Rotenberg","sequence":"additional","affiliation":[{"name":"Rehabilitation Sciences Institute, University of Toronto , Toronto ,","place":["Canada"]},{"name":"Department of Occupational Science and Occupational Therapy, University of Toronto , Toronto ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill I","family":"Cameron","sequence":"additional","affiliation":[{"name":"Rehabilitation Sciences Institute, University of Toronto , Toronto ,","place":["Canada"]},{"name":"Department of Occupational Science and Occupational Therapy, University of Toronto , Toronto ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J","family":"Oliver","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Sunnybrook Health Sciences Center , Toronto ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3930-2191","authenticated-orcid":false,"given":"Janine","family":"Farragher","sequence":"additional","affiliation":[{"name":"Rehabilitation Sciences Institute, University of Toronto , Toronto ,","place":["Canada"]},{"name":"Department of Occupational Science and Occupational Therapy, University of Toronto , Toronto ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"2026101002224441600_aajag099-B1","doi-asserted-by":"publisher","first-page":"5529","DOI":"10.3390\/jcm13185529","article-title":"Symptom burden in patients on maintenance hemodialysis: prevalence and severity 17 years apart","volume":"13","author":"Bossola","year":"2024","journal-title":"J Clin Med"},{"key":"2026101002224441600_aajag099-B2","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1053\/j.ajkd.2015.09.024","article-title":"Functional dependence and mortality in the international dialysis outcomes and practice patterns study (DOPPS)","volume":"67","author":"Jassal","year":"2016","journal-title":"Am J Kidney Dis."},{"key":"2026101002224441600_aajag099-B3","doi-asserted-by":"publisher","DOI":"10.1080\/0886022X.2024.2353341","article-title":"Medication burden in patients with dialysis-dependent CKD: a systematic review","volume":"46","author":"Liu","year":"2024","journal-title":"Ren Fail"},{"key":"2026101002224441600_aajag099-B4","doi-asserted-by":"publisher","DOI":"10.1177\/2054358118760832","article-title":"A province-wide, cross-sectional study of demographics and medication use of patients in hemodialysis units across Ontario","volume":"5","author":"Battistella","year":"2018","journal-title":"Can J Kidney Health Dis"},{"key":"2026101002224441600_aajag099-B5","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1159\/000494222","article-title":"Geriatric assessment in elderly patients with End-stage kidney disease","volume":"141","author":"Goto","year":"2019","journal-title":"Nephron Clin Pract"},{"key":"2026101002224441600_aajag099-B6","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1053\/j.ackd.2010.06.004","article-title":"Medication-related problems in CKD","volume":"17","author":"Cardone","year":"2010","journal-title":"Adv Chronic Kidney Dis"},{"key":"2026101002224441600_aajag099-B7","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1186\/2047-783X-14-5-185","article-title":"Adherence to prescribed oral medication in adult patients undergoing chronic hemodialysis: a critical review of the literature","volume":"14","author":"Schmid","year":"2009","journal-title":"Eur J Med Res"},{"key":"2026101002224441600_aajag099-B8","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1053\/j.ajkd.2015.12.028","article-title":"Cognition in people with End-stage kidney disease treated with hemodialysis: a systematic review and meta-analysis","volume":"67","author":"O\u2019Lone","year":"2016","journal-title":"Am J Kidney Dis."},{"key":"2026101002224441600_aajag099-B9","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1097\/01.mlr.0000114908.90348.f9","article-title":"Variations in patients\u2019 adherence to medical recommendations: a quantitative review of 50 years of research","volume":"42","author":"DiMatteo","year":"2004","journal-title":"Med Care"},{"key":"2026101002224441600_aajag099-B10","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1186\/s12882-017-0583-9","article-title":"Medication adherence perspectives in haemodialysis patients: a qualitative study","volume":"18","author":"Ghimire","year":"2017","journal-title":"BMC Nephrol"},{"key":"2026101002224441600_aajag099-B11","first-page":"1","volume-title":"Prospective Memory: Theory and Applications","author":"Ellis","year":"1996"},{"key":"2026101002224441600_aajag099-B12","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1681\/ASN.2018050462","article-title":"Investigating the relationship between cerebral blood flow and cognitive function in hemodialysis patients","volume":"30","author":"Findlay","year":"2019","journal-title":"J Am Soc Nephrol."},{"key":"2026101002224441600_aajag099-B13","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1186\/s12882-021-02333-x","article-title":"Cognitive performance in dialysis patients\u2014\u201cwhen is the right time to test?\u201d","volume":"22","author":"Karakizlis","year":"2021","journal-title":"BMC Nephrol"},{"key":"2026101002224441600_aajag099-B14","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1097\/JCP.0b013e318166dfed","article-title":"Assessment of medication management ability in middle-aged and older adults with bipolar disorder","volume":"28","author":"Depp","year":"2008","journal-title":"J Clin Psychopharmacol"},{"key":"2026101002224441600_aajag099-B15","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1093\/arclin\/acaa058","article-title":"The clinical utility and ecological validity of the medication management ability assessment in older adults with and without dementia","volume":"36","author":"Margolis","year":"2021","journal-title":"Arch Clin Neuropsychol"},{"key":"2026101002224441600_aajag099-B16","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment","volume":"53","author":"Nasreddine","year":"2005","journal-title":"J Am Geriatr Soc"},{"key":"2026101002224441600_aajag099-B17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0106700","article-title":"The Montreal cognitive assessment (MoCA)\u2014A sensitive screening instrument for detecting cognitive impairment in chronic hemodialysis patients","volume":"9","author":"Tiffin-Richards","year":"2014","journal-title":"PLoS One"},{"key":"2026101002224441600_aajag099-B18","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1093\/geront\/9.3_Part_1.179","article-title":"Assessment of older people: self-maintaining and instrumental activities of daily living","volume":"9","author":"Lawton","year":"1969","journal-title":"Gerontologist."},{"key":"2026101002224441600_aajag099-B19","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.1038\/ki.2008.62","article-title":"Functional dependencies among the elderly on hemodialysis","volume":"73","author":"Cook","year":"2008","journal-title":"Kidney Int"},{"key":"2026101002224441600_aajag099-B20","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/j.schres.2011.07.022","article-title":"Sensitivity and specificity of the UCSD performance-based skills assessment (UPSA-B) for identifying functional milestones in schizophrenia","volume":"132","author":"Mausbach","year":"2011","journal-title":"Schizophr Res"},{"key":"2026101002224441600_aajag099-B21","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000039971","article-title":"Impact of a multimodal health education combined with teach-back method on self-management in hemodialysis patients: a randomized controlled trial","volume":"103","author":"Liu","year":"2024","journal-title":"Medicine (Baltimore)"},{"key":"2026101002224441600_aajag099-B22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0231350","article-title":"Teach-back: a systematic review of implementation and impacts","volume":"15","author":"Talevski","year":"2020","journal-title":"PLoS One"},{"key":"2026101002224441600_aajag099-B23","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.cct.2012.09.005","article-title":"A multifaceted prospective memory intervention to improve medication adherence: design of a randomized control trial","volume":"34","author":"Insel","year":"2013","journal-title":"Contemp Clin Trials"},{"key":"2026101002224441600_aajag099-B24","doi-asserted-by":"publisher","first-page":"1743","DOI":"10.1017\/S1041610213001233","article-title":"A literature review of spaced-retrieval interventions: a direct memory intervention for people with dementia","volume":"25","author":"Creighton","year":"2013","journal-title":"Int Psychogeriatr"},{"key":"2026101002224441600_aajag099-B25","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.2215\/CJN.01090210","article-title":"Prevalence and correlates of cognitive impairment in hemodialysis patients: the frequent hemodialysis network trials","volume":"5","author":"Tamura","year":"2010","journal-title":"Clin J Am Soc Nephrol."},{"key":"2026101002224441600_aajag099-B26","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-025-02407-8","article-title":"Association between patient race\/ethnicity, health literacy, socio-economic Status, and incidence of medication errors: a systematic review","author":"Suen","year":"2025","journal-title":"J Racial Ethn Health Disparities"},{"key":"2026101002224441600_aajag099-B27","doi-asserted-by":"publisher","first-page":"2364","DOI":"10.1007\/s11606-023-08082-x","article-title":"Predicted health literacy disparities between immigrant and US-born racial\/ethnic minorities: a nationwide study","volume":"38","author":"Sepassi","year":"2023","journal-title":"J Gen Intern Med"},{"key":"2026101002224441600_aajag099-B28","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1001\/jama.2021.9907","article-title":"Trends in differences in health status and health care access and affordability by race andethnicity in the United States, 1999-2018","volume":"326","author":"Majahan","year":"2021","journal-title":"JAMA"},{"key":"2026101002224441600_aajag099-B29","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glad271","article-title":"An incomplete model of disability: discrepancies between performance-based and self-reported measures of functioning","volume":"79","author":"Twardzik","year":"2024","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2026101002224441600_aajag099-B30","first-page":"16","article-title":"A guide for considering performance-based assessments when determining a patient's capacity for safe, independent living","volume":"63","author":"Moore","year":"2008","journal-title":"Geriatrics"}],"container-title":["Journal of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/joneph\/article-pdf\/39\/6\/1230\/70617104\/aajag099.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/joneph\/article-pdf\/39\/6\/1230\/70617104\/aajag099.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:22:51Z","timestamp":1791613371000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/joneph\/article\/39\/6\/1230\/8759476"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":30,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,8,12]]},"published-print":{"date-parts":[[2026,10,10]]}},"URL":"https:\/\/doi.org\/10.1093\/joneph\/aajag099","relation":{},"ISSN":["1121-8428","1724-6059"],"issn-type":[{"value":"1121-8428","type":"print"},{"value":"1724-6059","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7]]},"published":{"date-parts":[[2026,7]]}}}