‘I just take them because I know the people that give them to me’: A theory‐informed interview study of community‐dwelling people with dementia and carers' perspectives of medicines management

• Published in: International journal of geriatric psychiatry 2021-06, Vol.36 (6), p.883-891
• Main Authors: Barry, Heather E., McGrattan, Máiréad, Ryan, Cristín, Passmore, A. Peter, Robinson, A. Louise, Molloy, Gerard J., Darcy, Carmel M., Buchanan, Hilary, Hughes, Carmel M.
• Format: Article
• Language: English
• Subjects: beliefs about medicines; carers; Cognitive ability; Data collection; Dementia; Dementia disorders; Disease management; Geriatric psychiatry; medicines management; primary health care; qualitative research; theoretical domains framework
• ISSN: 0885-6230; 1099-1166
• DOI: 10.1002/gps.5488

Objective Identify facilitators and barriers to successful medicines management for people with dementia (PwD) in primary care from the perspectives of community‐dwelling PwD and carers. Methods Semi‐structured interviews conducted with PwD and carers in Northern Ireland. The 14‐domain Theoretical Domains Framework guided data collection and analysis. Interviews explored participants' experiences and perceptions of medicines management. PwD also completed the Beliefs about Medicines Questionnaire indicating their level of agreement with statements about medicines. Qualitative data were analysed using the framework method and content analysis. Quantitative data were analysed descriptively. Results Eighteen PwD and 15 carers were interviewed. PwD believed they were competent with medicines management (‘beliefs about capabilities’). Most PwD reported having strategies to prompt them to take their medicines (‘memory, attention and decision processes’). Carers played an important role in supporting PwD with medicines management (‘social influences’) and monitoring adherence (‘behavioural regulation’) and anticipated having to take on a greater role as patients' cognitive impairment worsened (‘beliefs about consequences’). Participants highlighted assistance provided by community pharmacies with medicines acquisition and delivery (‘environmental context and resources’) and placed great trust in primary healthcare professionals (‘social influences’). PwD had positive attitudes towards medication and believed strongly in the necessity of their medicines. Conclusions This is the first study to use a theoretical approach to explore medicines management for community‐dwelling PwD. The findings provide new insights into the critical role of carers in facilitating optimal medicines management and will inform future intervention development, in which carers' needs assessment and involvement will be key. Key Points This study used qualitative methods to explore the experiences of community‐dwelling people with dementia (PwD) and their carers about medicines management. The beliefs of PwD about medicines were also determined using a validated questionnaire PwD generally did not perceive medicines management to be an issue for them at the time of interview and they displayed positive beliefs about medicines. All of the PwD interviewed had carer assistance with medicines. Carers were concerned about the future and how medicines management may become more problematic as the