School of Pharmacy, Queen's University Belfast, Belfast, UK.
The School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland.
Int J Geriatr Psychiatry. 2021 Jun;36(6):883-891. doi: 10.1002/gps.5488. Epub 2021 Jan 10.
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.
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.
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.
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.
从社区居住的痴呆症患者（PwD）和照护者的角度确定初级保健中成功管理药物的促进因素和障碍。
在北爱尔兰对 PwD 和照护者进行半结构化访谈。14 个领域的理论框架指导了数据收集和分析。访谈探讨了参与者对药物管理的经验和看法。PwD 还完成了关于药物的信念问卷，表明他们对药物的陈述的同意程度。使用框架方法和内容分析对定性数据进行分析。对定量数据进行描述性分析。
对 18 名 PwD 和 15 名照护者进行了访谈。PwD 认为他们有能力管理药物（“关于能力的信念”）。大多数 PwD 报告说有策略来提示他们服用药物（“记忆、注意力和决策过程”）。照护者在支持 PwD 管理药物（“社会影响”）和监测依从性（“行为调节”）方面发挥了重要作用，并预计随着患者认知能力的下降，他们将承担更大的角色（“关于后果的信念”）。参与者强调社区药房在药物获取和交付方面提供的帮助（“环境背景和资源”），并对初级保健专业人员非常信任（“社会影响”）。PwD 对药物持有积极的态度，并坚信他们的药物是必要的。
这是第一项使用理论方法探讨社区居住的 PwD 药物管理的研究。研究结果为照护者在促进最佳药物管理方面的关键作用提供了新的见解，并将为未来的干预措施的发展提供信息，其中照护者的需求评估和参与将是关键。
