School of Life & Health Sciences, Aston University, Birmingham, UK.
Faculty of Health Sciences, University of Hull, Hull, UK.
BMC Geriatr. 2017 Oct 18;17(1):242. doi: 10.1186/s12877-017-0638-6.
Little is known about the general medicines management issues for people with dementia living in the community. This review has three aims: firstly to explore and evaluate the international literature on how people with dementia manage medication; assess understanding of medicines management from an informal carers perspective; and lastly to understand the role that healthcare professionals play in assisting this population with medicines management.
A mixed studies review was conducted. Web of Knowledge, PubMed and Cochrane Library were searched post-1999 for studies that explored medicines management in people with dementia dwelling in the community, and the role healthcare professionals play in supporting medicines management in people with dementia. Following screening, nine articles were included. Data from included studies were synthesised using a convergent synthesis approach and analysed thematically to combine findings from studies using a range of methods (qualitative, quantitative and mixed methods).
Four themes were generated from the synthesis: The nature of the disease and the effects this had on medicines management; the additional responsibilities informal carers have; informal caregivers' knowledge of the importance of managing medication and healthcare professionals' understanding of medicines management in people with dementia. Consequently, these were found to affect management of medication, in particular adherence to medication.
This review has identified that managing medication for people with dementia dwelling in the community is a complex task with a frequently associated burden on their informal caregivers. Healthcare professionals can be unaware of this burden. The findings warrant the need for healthcare professionals to undergo further training in supporting medicines management for people with dementia in their own homes.
对于居住在社区中的痴呆症患者的一般药物管理问题知之甚少。本次综述有三个目的：首先，探索和评估国际文献中关于痴呆症患者如何管理药物的情况；评估非专业照护者对药物管理的理解；最后，了解医疗保健专业人员在协助这一人群进行药物管理方面所扮演的角色。
进行了一项混合研究综述。在 1999 年之后，通过 Web of Knowledge、PubMed 和 Cochrane Library 搜索了探索居住在社区中的痴呆症患者药物管理以及医疗保健专业人员在协助痴呆症患者药物管理方面所扮演的角色的国际文献。经过筛选，纳入了九篇文章。使用汇集合成方法对纳入研究的数据进行综合，并使用主题分析方法对来自使用各种方法（定性、定量和混合方法）的研究的结果进行分析。
综合分析产生了四个主题：疾病的性质及其对药物管理的影响；非专业照护者的额外责任；非专业照护者对管理药物重要性的了解以及医疗保健专业人员对痴呆症患者药物管理的理解。因此，这些因素被认为会影响药物管理，特别是药物的依从性。
本次综述表明，对于居住在社区中的痴呆症患者的药物管理是一项复杂的任务，他们的非专业照护者通常会承担相关负担。医疗保健专业人员可能没有意识到这一负担。研究结果表明，有必要对医疗保健专业人员进行进一步培训，以支持他们在自己家中为痴呆症患者管理药物。
