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Determinants of medication adherence in older people with dementia from the caregivers’ perspective

Published online by Cambridge University Press:  11 May 2018

Najwan El-Saifi ,
Wendy Moyle Open the ORCID record for Wendy Moyle [Opens in a new window] ,
Cindy Jones  and
Clair Alston-Knox
Najwan El-Saifi*
Affiliation:
Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
Wendy Moyle
Affiliation:
Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
Cindy Jones
Affiliation:
Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
Clair Alston-Knox
Affiliation:
Griffith Social and Behavioral Research College, Griffith University, Brisbane, Queensland, Australia
*
Correspondence should be addressed to: Najwan El-Saifi, Menzies Health Institute Queensland, Griffith University, Nathan Campus, Brisbane, Queensland 4111, Australia. Phone: +61-450-235575. Email: najwan.elsaifi@griffithuni.edu.au.
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Abstract

Background:

Adherence to treatment is a primary determinant of treatment success. Caregiver support can influence medication adherence in people with cognitive impairment. This study sought to characterize medication adherence in older people with dementia from the caregivers’ perspective, and to identify influencing factors.

Methods:

Caregivers caring for a person with dementia and living in the community were eligible to complete the survey. Bayesian profile regression was applied to identify determinants of medication adherence measured using the Adherence to Refills and Medication Scale.

Results:

Out of the 320 caregivers who participated in the survey, Bayesian profile regression on 221 participants identified two groups: Profile 1 (55 caregivers) with a mean adherence rate of 0.69 (80% Credible Interval (CrI): 0.61–0.77), and Profile 2 (166 caregivers) with a mean adherence rate of 0.80 (80% CrI: 0.77–0.84). Caregivers in Profile 1 were characterized with below data average scores for the following: cognitive functioning, commitment or intention, self-efficacy, and health knowledge, which were all above the data average in Profile 2, except for health knowledge. Caregivers in Profile 1 had a greater proportion of care recipients taking more than five medications and with late-stage dementia. Trade, technical, or vocational training was more common among the caregivers in Profile 1. Profile 2 caregivers had a better patient–provider relationship and less medical problems.

Conclusions:

Bayesian profile regression was useful in understanding caregiver factors that influence medication adherence. Tailored interventions to the determinants of medication adherence can guide the development of evidence-based interventions.

Keywords

dementiamedication adherencecaregiversBayesian profile regression
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 3: Issue Theme: Caregiving for People with Dementia , March 2019 , pp. 331 - 339
Copyright
Copyright © International Psychogeriatric Association 2018 

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