{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T09:23:33Z","timestamp":1787822613862,"version":"build-2784847793"},"reference-count":42,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100011822","name":"Michigan Health Endowment Fund","doi-asserted-by":"publisher","award":["2007\u2010146990"],"award-info":[{"award-number":["2007\u2010146990"]}],"id":[{"id":"10.13039\/100011822","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Polypharmacy affects nearly 50% of older adults, increasing risks of adverse drug events, falls, and hospitalizations. While patient\u2010centered educational interventions show promise, optimal delivery formats remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This pragmatic quasi\u2010experimental study was conducted May to September 2025 in Michigan using venue\u2010based allocation. Participants received identical educational content through either in\u2010person presentation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200960) or self\u2010paced packet with pamphlet, video, and multimedia formats (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200980). Educational components included the World Health Organization Five Moments for Medication Safety framework and a study\u2010developed drug list collection tool. The primary outcome was medication management confidence (5\u2010point Likert scale). Secondary outcomes included polypharmacy knowledge, self\u2010efficacy, and tool adoption intentions. Paired t\u2010tests assessed pre\u2010post changes, and analysis of covariance compared formats adjusting for age, sex, race, thyroid disorder, arthritis, and baseline confidence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The sample (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009140, mean age 70.0\u2009\u00b1\u200912.0\u2009years, 57.1% female, 82.1% White) showed significant improvement in medication management confidence (mean change\u2009=\u20090.24 points, 95% CI: 0.12 to 0.36,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, d\u2009=\u20090.33). Both formats demonstrated significant within\u2010group improvements (in\u2010person: 0.32 points,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005; self\u2010paced: 0.19 points,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010). After covariate adjustment, no significant difference existed between formats (adjusted difference: 0.01 points,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.911). Knowledge of polypharmacy definition improved from 82.9% to 97.1%. Post hoc power analysis indicated the study was powered to detect moderate between\u2010format differences (d\u2009\u2265\u20090.48); the observed between\u2010format effect (d\u2009=\u20090.18) was smaller, suggesting any true difference is likely small rather than moderate or large.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both formats produced significant improvements in medication management confidence and knowledge, with no significant difference between delivery formats after adjustment. These findings support flexible implementation strategies, allowing delivery approaches based on resource availability, patient needs, and setting with potential for scalable dissemination to populations facing transportation, scheduling, or mobility barriers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70450","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T03:54:57Z","timestamp":1776225297000},"page":"2398-2409","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparing In\u2010Person Versus Self\u2010Paced Polypharmacy Education in Older Adults: A Pragmatic Comparison of Delivery Format Effectiveness"],"prefix":"10.1111","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2410-8555","authenticated-orcid":false,"given":"Caleb","family":"Zimmerman","sequence":"first","affiliation":[{"name":"College of Medicine Central Michigan University  Mt. Pleasant Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christya","family":"Haddad","sequence":"additional","affiliation":[{"name":"College of Medicine Central Michigan University  Mt. Pleasant Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Himmel","sequence":"additional","affiliation":[{"name":"College of Science and Engineering Central Michigan University  Mt. Pleasant Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Thomas","sequence":"additional","affiliation":[{"name":"College of Human Medicine Michigan State University  Lansing Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewis","family":"Macdonald","sequence":"additional","affiliation":[{"name":"Biomedical Sciences Department Grand Valley State University  Allendale Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"Smith","sequence":"additional","affiliation":[{"name":"College of Science and Engineering Central Michigan University  Mt. Pleasant Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean","family":"Dalman","sequence":"additional","affiliation":[{"name":"College of Osteopathic Medicine A.T. Still University  Kirksville Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Fakhoury","sequence":"additional","affiliation":[{"name":"College of Medicine Central Michigan University  Mt. Pleasant Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyotsna","family":"Pandey","sequence":"additional","affiliation":[{"name":"College of Medicine Central Michigan University  Mt. Pleasant Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010017\u20100621\u20102"},{"key":"e_1_2_10_3_1","volume-title":"StatPearls","author":"Varghese D.","year":"2025"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41256\u2010023\u201000311\u20104"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0098043"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0004439"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3181e89905"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042098615615472"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.329.7456.15"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875\u2010018\u20100825\u20103"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.10351"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16141"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/JMQ.0000000000000227"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912\u2010022\u201001061\u20103"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjopharm.2011.07.005"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102125.2003.02007.x"},{"issue":"2","key":"e_1_2_10_17_1","first-page":"90","article-title":"Continuing Challenges in Rural Health in the United States","volume":"5","author":"Coughlin S. 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