New research funded by Pharmacy Research UK and published in Health Expectations, reveals people with dementia may struggle with managing their medication – exposing them to side-effects, medication errors and an increased risk of non-adherence to drug treatment.
Researchers at Aston University, Hull University and the UEA interviewed family carers, people with dementia, nurses, GPs and community pharmacists for the project.
Their year-long research found that as dementia develops the person struggles to manage their own medication and increasingly relies on support from family carers. This is often their partner, who may also be taking many medicines and finding the carer role stressful, thus increasing the risk of medication error.
The study showed that for some carers this was a real burden of responsibility and that they hid their anxieties.
Lead researcher Dr Ian Maidment, Senior Lecturer in Clinical Pharmacy at Aston said: “Our study found incorrect dosing, forgetting to give the medication and taking medicines which should have been stopped.”
Professor Chris Fox, Consultant Old Age Psychiatrist from UEA’s Norwich Medical School said: “There can be severe health impact for both the patient and carer – too often in my clinical practice I come across patients and families overburdened and unclear about their medication regimes. This can result in more visits to their GP and hospital and is a cause of avoidable NHS admissions.”
Dr Andrea Hilton from Hull University added: “There is a substantial role for community pharmacists and their teams to assist carers; many pharmacists have day-to-day contact both with carers and people with dementia. Community pharmacy is in a unique position to support and embrace patient-centred care and this is currently under-utilised. This research highlights that community pharmacists should be working more with GP practices and have full access to patients’ medical records. Furthermore, home visits should be conducted for medication reviews.”
Barbara Woodward-Carlton a former carer and a member of the Alzheimer’s Society Research Network highlighted: “During the years I looked after my mother who had Alzheimer’s disease I wish I had known what help I could have had from community pharmacists.
“My mother was an extremely pleasant person who always wanted to co-operate but found it incomprehensible that she should be taking any medication at all. At one point when she was very ill, I continued the medication she had been given including ‘water tablets’ without realising that she was dehydrated. I live with the shame of not knowing that as she was barely drinking and eating I should have stopped that medication. I welcome that community pharmacists are increasingly seen as those who can advise, educate and help those of us who care for others.”
Dr Clare Walton, Research Manager at Alzheimer’s Society said: “Seven in 10 people with dementia are also living with other health conditions and managing multiple medications which can be a tremendous challenge. Finding new and innovative ways to support people with dementia and their carers to safely and correctly age their medication is a focus for future research.”
Ian Maidment added: “People with dementia are amongst the most vulnerable members of society and need more support with medication management. We need to develop new ways of supporting people with dementia manage their management and then test how well these new ways work.”
Article: A qualitative study exploring medication management in people with dementia living in the community and the potential role of the community pharmacist, Ian D. Maidment PhD, Lydia Aston MA, Tiago Moutela MA, Chris G. Fox MBBS Bsc Mmmedsci MRCPsych MD, Andrea Hilton PhD, Health Expectations, doi: 10.1111/hex.12534, published 19 January 2017.