""""""""Strategies to improve caregiver mediated medication management of community dwelling patients with dementia"""""""". Reducing medication errors, a priority patient safety issue, is of concern not only within formal healthcare settings but also when family members must assist with managing medications of others, particularly adults with dementia. Errors may occur during medication storage, preparation, and administration and may lead to adverse events including unplanned doctor's visits, visits to the emergency rooms, and hospitalizations. This study will address this significant problem by testing the efficacy of a tailored caregiver mediated medication management in-home and telephone delivered intervention designed to decrease medication deficiencies and daily hassles and improve self-reported adherence for caregivers of community dwelling patients with dementia vs. standard education/usual care group of caregivers over time. The secondary aims will (1) examine the efficacy of the intervention on (a) health related quality of life (QoL) in both caregivers and community dwelling patients and (b) subsequent adverse patient outcomes (unplanned doctor's visits, emergency room visits, and hospitalizations) over time, and (2) examine the relationship between medication taking deficiencies, daily hassles, and self-reported adherence and adverse patient outcomes (unplanned doctor's visits, emergency room visits, and hospitalizations) over time. We will recruit patients with dementia and their caregivers from primary care geriatric facilities and community organizations serving the elderly. Eligible patient/caregiver dyads will be randomized into control/usual care or intervention. The tailored caregiver mediated medication management will include a series of home visits and telephone calls designed to increase the caregiver's problem solving ability and self-confidence related to safe medication management. Data will be collected at baseline, post intervention, post maintenance, and at follow-up. We will use repeated measures analysis to test for differences in the two groups over time. For the program project we will explore possible predictors of adherence, medication taking deficiencies, and health-related QoL. Descriptive statistics will summarize translation parameters. Potentially, this intervention may reduce healthcare costs, improve QoL, and be translated into practice settings such as geriatrician's offices, home health nursing, social work and nursing case management, and lay community groups.
