Medication Management in People with Dementia in the Community

A qualitative scoping study exploring the role of the community pharmacist in medication management in people with dementia dwelling in the community, September 2014 to July 2016

Dr Ian Maidment, Aston University

The number of people with dementia is rapidly increasing as the population ages. Older people with dementia receive many different medicines both for the underlying dementia and other diseases associated with old age. However, as well as treating disease, medication can cause harm and evidence suggests that older people with dementia may be at special risk of medication-related harm, partly because as the dementia worsens the person with dementia may no longer be able to “self-medicate” and family carers may be forced to look after the medication of the person they care for with dementia. Scoping work by the lead researcher with the Alzheimer’s Society has identified family carers do not feel equipped for such a role and they find the role stressful (this work is described in a recent Alzheimer’s Society newsletter www.alzheimers.org.uk/site/scripts/download_info.php?downloadID=988). Community Pharmacists provide an accessible nationwide network of healthcare professionals on the high street, and could have a role supporting people with dementia and their family carers to manage their medication.

Little is known about the role of the family carer in safe medication management in dementia and how community pharmacy could help. Therefore, we will use qualitative research methods to explore the subject, understand the key issues and develop potential solutions. Initially, we will interview up to 30 people with dementia and their family carer to identify the range and type of medication-related problems while also exploring the reasons for, and potential consequences of medication-related problems. We will then interview health and social care professionals (doctors, nurses, pharmacists, care workers) to understand the key problems and identify ways to improve how medicines are managed and how community pharmacists can help. We will also review the literature to identify areas of good practice. From the interviews we will develop an outline new role for community pharmacists and then present the outline role to experts in the field to identify any barriers or facilitators.

The results will be made widely available and communicated locally, nationally and internationally to key stakeholders to include carers, people with dementia, clinicians and academics. We will use our links with professional bodies, the Department of Health and the Alzheimer’s Society Policy Department to support this dissemination. Once the new role has been finalised we will test its impact in a future research project (clinical trial).

See more information on this area in Dr Maidment’s research programme.

This project has now been completed.  See the main findings, executive summary and full report.