Study area and design
This was a descriptive cross-sectional study conducted from February to July, 2018 at Muhimbili National Hospital (MNH) outpatient pharmacy outlets. MNH is a national referral tertiary level research center and university teaching hospital with 1,500 beds facility, attending 1,000 to 1,200 outpatients per day. The hospital is well equipped with laboratories, modern diagnostic facilities, specialized clinics as well as highly skilled manpower in all cadres of healthcare providers.
Study population and sample size
To be included in this study participant was supposed to be; 1) from outpatient clinic in MNH 2) carrying a prescription with more than one drug for oral use 3) carrying medicines he/she has received from pharmaceutical personnel at MNH outpatient pharmacy outlets 3) not blind 4) not deaf 5) sober 6) not a guardian 7) with a regimen of more than three days of use. Owing to scarcity of data on prevalence of level of medication management capacity (MMC) the 50% proportion was set as a reference population proportion to calculate the sample size. At the Z-score of 1.96 and margin of error of 5% the sample size was 385. To consider for partial filled or inconsistency 10% of initial sample was added to make 424.
Consecutive sampling was employed to recruit study participants. The researcher stayed at the exit point of the outpatient pharmacy building. When the client was about to get outside the pharmacy building the researcher requested him/her for a brief discussion. If the client agreed, the purpose of the study was explained, and then he/she signed freely obtained consent form. Assessment for inclusion and exclusion criteria was done and those who fulfilled requirements were asked to continue with the interview.
Face-to-face interview using semi-structured questionnaire was used to gather data for fulfilling this study objectives. The questionnaire consisted questions and directives to assess medication self management capacity. This was a minor modified adoption of DRUGS tool which was used by Kripalani and colleague  in assessing MMC. On medication identification part; patient was asked to read what has been written on the prescription, show the particular drug, tell about warning, precaution or contraindication, important possible side effects and interactions with food or other drugs on the prescription. The researcher used Medscape interaction checker online software to check for potential life threatening interaction and match with the participant’s response. The patient was then asked to open the identified drug and the researcher observed the process of opening. After opening the container, the patient was asked to tell the number of tablet(s) or amount of syrup/suspension/solution which he/she is suppose to be taking per dose. Finally the patient was asked to tell the researcher about intervals of time to take the next dose and the total duration he/she will be using the medication. The steps were repeated for each of the medication on the prescription. For each question, the overall response was correct only if the participant has managed to perform a particular task correctly for all the prescribed medications on the prescription. Modified Bloom cut off point from study by Abdullah and colleagues  was used to categorize the MMC of the participants. The MMC was rated as poor/inadequate (score <50%), moderate (score: 50-59%), good (score: 60-69%), very good (70-79%) and excellent (80-100%).
Analysis was done using statistical package for social sciences (SPSS) version 23. Categorical data like gender, age groups, levels of education, level of MMC were summarized using frequency distribution and bar charts.