Gench Melissa, Sawan Mouna J, Langford Aili, Gnjidic Danijela
School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.
Health Expect. 2021 Oct;24(5):1570-1581. doi: 10.1111/hex.13318. Epub 2021 Jul 21.
Caregivers often undertake medication management for people living with dementia without formal training. There is a need to evaluate caregiver medication management practices for people living with dementia to identify and address the key issues that contribute to caregiver burden.
This study aimed to identify and summarize approaches that evaluate medication management for caregivers of people living with dementia and appraise caregiver's involvement in aspects of medication management.
A systematic search was undertaken in five databases: Medline, Embase, PsycINFO, Scopus and International Pharmaceutical Abstracts. Studies written in English that contained tools and surveys that evaluated aspects of medication management for caregivers of PWD were included.
A total of 10 studies were included. Medication selection was assessed in six studies, supply and monitoring/review was captured in seven studies, with administration assessed in nine studies. Caregivers were commonly involved in decision-making for medication changes (77.1%-86.8%) and in the ordering (55.9%-86.0%) and collection (87.0%-92.4%) of medications. Reported caregiver involvement in medication administration showed a wide range (44%-94.7%) between the studies. Challenges in administration were commonly related to polypharmacy and dosage regimen complexity.
Current tools capture specific aspects of medication management, with medication administration the most evaluated aspect of medication management. Future research is needed to develop a tool to holistically evaluate the complexities of medication management for caregivers of people living with dementia to minimize adverse events at transitions of care.
From the authors' previous research, caregivers highlighted the need to address key issues in medication management for people living with dementia.
照顾者常常在未接受正规培训的情况下，为痴呆症患者进行药物管理。有必要评估痴呆症患者照顾者的药物管理实践，以识别并解决导致照顾者负担的关键问题。
本研究旨在识别并总结评估痴呆症患者照顾者药物管理的方法，并评估照顾者在药物管理各方面的参与情况。
在五个数据库中进行了系统检索：医学文献数据库（Medline）、荷兰医学文摘数据库（Embase）、心理学文摘数据库（PsycINFO）、Scopus数据库和国际药学文摘数据库（International Pharmaceutical Abstracts）。纳入了以英文撰写的、包含评估痴呆症患者照顾者药物管理各方面的工具和调查的研究。
共纳入10项研究。六项研究评估了药物选择，七项研究涉及药物供应及监测/复查，九项研究评估了给药情况。照顾者通常参与药物变更的决策（77.1%-86.8%）以及药物的订购（55.9%-86.0%）和取药（87.0%-92.4%）。各研究中报道的照顾者参与给药的比例差异很大（44%-94.7%）。给药方面的挑战通常与多重用药和给药方案复杂有关。
现有工具涵盖了药物管理的特定方面，其中给药是药物管理中评估最多的方面。未来需要开展研究，开发一种工具，以全面评估痴呆症患者照顾者药物管理的复杂性，从而在护理过渡期间将不良事件降至最低。
根据作者之前的研究，照顾者强调需要解决痴呆症患者药物管理中的关键问题。
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