Interventions for self-management of medicines for community-dwelling people with dementia and mild cognitive impairment and their family carers: a systematic review

Author:

Powell Catherine12ORCID,Tomlinson Justine123ORCID,Quinn Catherine42ORCID,Fylan Beth152

Affiliation:

1. School of Pharmacy and Medical Sciences , University of Bradford, Bradford, UK

2. Wolfson Centre for Applied Health Research , Bradford, UK

3. Medicines Management & Pharmacy Services , Leeds Teaching Hospitals NHS Trust, Leeds, UK

4. Centre for Applied Dementia Studies , University of Bradford, Bradford, UK

5. NIHR Yorkshire and Humber Patient Safety Translational Research Centre , Bradford Institute for Health Research, Bradford, UK

Abstract

Abstract Background people with dementia or mild cognitive impairment (MCI) and their family carers face challenges in managing medicines. How medicine self-management could be supported for this population is unclear. This review identifies interventions to improve medicine self-management for people with dementia and MCI and their family carers, and the core components of medicine self-management that they address. Methods a database search was conducted for studies with all research designs and ongoing citation search from inception to December 2021. The selection criteria included community-dwelling people with dementia and MCI and their family carers, and interventions with a minimum of one medicine self-management component. The exclusion criteria were wrong population, not focusing on medicine management, incorrect medicine self-management components, not in English and wrong study design. The results are presented and analysed through narrative synthesis. The review is registered [PROSPERO (CRD42020213302)]. Quality assessment was carried out independently applying the QATSDD quality assessment tool. Results 13 interventions were identified. Interventions primarily addressed adherence. A limited number focused on a wider range of medicine self-management components. Complex psychosocial interventions with frequent visits considered the person’s knowledge and understanding, supply management, monitoring effects and side effects and communicating with healthcare professionals, and addressed more resilience capabilities. However, these interventions were delivered to family carers alone. None of the interventions described patient and public involvement. Conclusion interventions, and measures to assess self-management, need to be developed which can address all components of medicine self-management to better meet the needs of people with dementia and MCI and their family carers.

Funder

National Institute for Health Research

Publisher

Oxford University Press (OUP)

Subject

Geriatrics and Gerontology,Aging,General Medicine

Reference47 articles.

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2. Comorbidity and polypharmacy in people with dementia: insights from a large, population-based cross-sectional analysis of primary care data;Clague;Age Ageing,2016

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