Abstract
ObjectivesMedicines play a key role in the lives of people with dementia, primarily to manage symptoms. Managing medicines is complex for people with dementia and their family carers and can result in multiple problems leading to harm. We conducted a systematic review to identify and model medication issues experienced and coping strategies used by people with dementia and/or family carers.MethodsEleven general databases and four systematic review databases were searched. Studies were quality assessed using an established framework and thematically analysed.ResultsTwenty‐one articles were included in this study, and four domains affecting medication use were identified: cognitive, medication, social and cultural, and knowledge/educational and communication. People with dementia reported medication issues in all four domains, but few coping strategies were developed. Family carers reported issues and coping strategies related to the medication and knowledge/educational and communication domains. Common issues with regards to knowledge and communication about medicines remain unresolved. The “voices” of people with dementia appeared largely missing from the literature so were in‐depth understanding of how, whether, and in which circumstances coping strategies work in managing medicines.ConclusionsMedicines management is a complex set of activities and although current coping strategies exists, these were primarily used by family carers or the person with dementia‐carer dyad. Health and social care practitioners and researchers should seek to understand in‐depth the “mechanisms of action” of existing coping strategies and actively involve people with dementia as co‐producers of knowledge to underpin any further work on medicines management.
Highlights
Dementia is a chronic progressive impairment of cognitive function[1] caused by various conditions affecting the brain, for example Alzheimer's disease and repeated head trauma.[2]
Caregivers indicated that a lack of information and access to support to inform their medication management role added to their stress, which was exacerbated in some cases by limited English proficiency
A total of 19 semi structured interviews were conducted with 14 family carers and 5 care recipient (PLWD) who were identified through a memory clinic in London
Summary
Dementia is a chronic progressive impairment of cognitive function (including memory, reasoning, decision‐making)[1] caused by various conditions affecting the brain, for example Alzheimer's disease and repeated head trauma.[2] Globally, dementia presents a critical challenge to both health and social care services.[3] In the United Kingdom (UK), an estimated 850 000 people currently live with dementia, and, Int J Geriatr Psychiatry. There is currently no cure for dementia, medicines play a key role in the lives of people with dementia, primarily to manage symptoms.[10] Some people with dementia may be prescribed medication for comorbid health conditions such asType 2 Diabetes Mellitus or high blood pressure.[11] Unsurprisingly, given their cognitive problems, managing medication is complex for people with dementia which can result in “medication errors, medication related hospital admissions, and dependence on others to assist with medication management tasks”.12. Given their cognitive problems, managing medication is complex for people with dementia which can result in “medication errors, medication related hospital admissions, and dependence on others to assist with medication management tasks”.12 non‐adherence to medication is a widespread problem across conditions, ages, and other demographics, and can be intentional or unintentional,[13] cognitive impairment and dementia have been shown to impact on medication adherence
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