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Center for Health Services and Outcomes Research

Aging

Involving Family to Improve Communication about Safe and Effective Medication Use for Older Primary Care Patients with Dementia

Used appropriately, medications are vital in the successful management of chronic conditions. However, more than half of persons with chronic medical illnesses have difficulty adhering to medications, and an estimated 20-60% of older adults take one or more medication that is potentially inappropriate. Because persons with dementia have a high burden of co-occurring medical conditions and significant exposure to prescribed and over-the-counter medications, they are especially susceptible to potentially inappropriate medication use. The effects of dementia on memory, information processing, and judgment leave persons with dementia less able to manage and adhere to medications, placing them at heightened risk for medication-related adverse events such as hospitalization and death.

Accumulating evidence supports the feasibility and benefit of reducing medication complexity and the importance of patient and family factors to such efforts. Although there is consensus that medical communication is foundational in the formulation of a patient-centered treatment regimen and successful adherence to treatments, no evidence-based strategies address the reality that older persons with dementia commonly attend medical visits and manage medications with help from a family caregiver. This developmental study will refine a prototype intervention to more effectively and purposely involve family caregivers in medication-related deliberations during primary care visits of older persons with dementia.