Enhancing medicines management in people living with dementia

Dann-Reed, Eleanor (2019) Enhancing medicines management in people living with dementia. Doctoral thesis, University of East Anglia.

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Abstract

Background: By 2025 there will be over 1 million people living with dementia (PWD) in the UK. Many will develop pneumonia, one of the leading causes of hospitalisation and mortality amongst PWD.
PWD are often prescribed several medicines for a range of health conditions and therefore themselves or their carer need to visit their local community pharmacy regularly. Community pharmacies therefore have the potential to provide greater medicines support to this population.

Aim: This study aimed to develop the evidence base and theory to underpin the development of a community pharmacy intervention which would support people living with dementia within the community.

Methods: Following Medical Research Council guidance for developing an intervention, three studies were conducted to provide elements to be incorporated into a logic model. Firstly, a narrative review of interventions which were targeted at PWD and involved a member of the pharmacy team. Secondly, a case-controlled study using a primary care database to determine the risk factors associated with PWD developing pneumonia. Thirdly, an observational study of PWD living at home to provide a contextualised account of how PWD currently manage their medicines.

Results: The review identified medicine reviews, targeted medicine interventions and memory screening services targeted to PWD which often used a multi-disciplinary team. The case-controlled project showed that dysphagia, chronic obstructive pulmonary disease and liquid formulations were all associated with increased risk of pneumonia in PWD. The observational study showed how the incorporation of medicines into routines is important for effective medicines management.

Conclusion: This study identified that a community pharmacy led intervention could potentially include: Identifying signs of dysphagia, ensuring appropriate formulations are prescribed, exploring the routines of PWD to see how medicines can be better incorporated and using a multidisciplinary team to its best effect. Additional pharmacist training would be required to deliver this.

Keywords: dementia, community pharmacy, intervention, medicines management

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Science > School of Pharmacy
Depositing User: Gillian Aldus
Date Deposited: 15 Oct 2019 12:09
Last Modified: 15 Oct 2019 12:09
URI: https://ueaeprints.uea.ac.uk/id/eprint/72596
DOI:

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