A qualitative study exploring medication management in people with dementia living in the community and the potential role of the community pharmacist

摘要

Background: The prevalence of dementia is increasing rapidly. People with dementiamay be prescribed complex medication regimens, which may be challenging for themand any carers involved to safely manage. Objective: To describe and understand the key challenges, in relation to medicationissues, experienced by people with dementia and their informal carers dwelling in thecommunity and the potential role of community pharmacists. Design: Qualitative semi-structuredinterviews. Participants: People with dementia, informal carers and health and social care professionals(HSCPs). Results: Thirty-oneparticipants (eleven informal carers, four people with dementiaand sixteen HSCPs) were interviewed. Three key themes were identified: the key challenges,improving medication management and the role of pharmacists. The caringrole commonly included responsibility for medication management which createdboth practical problems and an emotional burden. This burden was worsened by anydifficulty in obtaining support and if the person with dementia was on a complex regimen. Participants believed that the process could be improved by coordinated and on-goingsupport from HSCPs, which should focus on the informal carer. Medicationreviews, particularly when conducted in the home environment, could be helpful. Conclusion: Medication management for people with dementia living in the communityis a complex process, and informal carers have a key role, which they frequently findchallenging. Community pharmacists could have an enhanced role in this area, but wouldneed to work within a more multidisciplinary environment outside the pharmacy.