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Training persons with early-stage Alzheimer’s disease how to use an electronic medication management device: development of an intervention protocol

Published online by Cambridge University Press:  22 January 2021

Myriam Tellier ,
Claudine Auger  and
Louise Demers
Myriam Tellier*
Affiliation:
School of rehabilitation, Université de Montréal, Montréal, Canada Center of interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada Centre de recherche de l’institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Canada
Claudine Auger
Affiliation:
School of rehabilitation, Université de Montréal, Montréal, Canada Center of interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
Louise Demers
Affiliation:
School of rehabilitation, Université de Montréal, Montréal, Canada Centre de recherche de l’institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Canada
*
*Corresponding author. Email: myriam.tellier@umontreal.ca
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Abstract

Background/Objectives:

Medication management is challenging for persons with Alzheimer’s disease (AD) and their caregivers. Electronic medication management devices (eMMDs) are specifically designed to support this task. However, theory-driven interventions for eMMD training with this population are rarely described. This study aimed to develop and assess the appropriateness of an intervention protocol to train persons with early-stage AD how to use an eMMD.

Methods:

Interviews with three categories of participants [persons with early-stage AD (n = 3), caregivers (n = 3), and clinicians (n = 3)] were conducted to understand medication management needs, perceived usefulness of an eMMD, and to explore training strategies. Subsequently, this knowledge was integrated in an intervention protocol which was validated with the three clinicians. A content analysis led to iterative modifications to maximize the acceptability and coherence of the intervention protocol in a homecare context.

Results:

The final intervention protocol specifies the expertise required to provide the training intervention and the target population, followed by an extensive presentation of eMMD features. Specific learning strategies tailored to the cognitive profile of persons with AD with step-by-step instructions for clinicians are included. Finally, it presents theoretical information on cognitive impairment in AD and how eMMDs can support them.

Conclusions:

This intervention protocol with its theoretical and pragmatic foundation is an important starting point to enable persons with early-stage AD to become active users of eMMDs. Next steps should evaluate the immediate and long-term impacts of its implementation on medication management in the daily lives of persons with AD and their caregivers.

Keywords

Self carerehabilitationinformation technologymedication therapy managementAlzheimer’s disease
Type
Articles
Information
Brain Impairment , Volume 22 , Issue 3 , December 2021 , pp. 329 - 342
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Australasian Society for the Study of Brain Impairment

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References

Baddeley, A., & Wilson, B. A. (1994). When implicit learning fails: Amnesia and the problem of error elimination. Neuropsychologia, 32(1), 53–68.CrossRefGoogle ScholarPubMed
Bartfai, A., & Boman, I.-L. (2014). A multiprofessional client-centred guide to implementing assistive technology for clients with cognitive impairments. Technology and Disability, 26(1), 11–21.CrossRefGoogle Scholar
Bier, N., Desrosiers, J., & Gagnon, L. (2006). Prise en charge cognitive de la mémoire dans le vieillissement normal, les troubles cognitifs légers et la démence de type Alzheimer [Cognitive management of memory in normal aging, mild cognitive impairment and Alzheimer’s disease]. Canadian Journal of Occupational Therapy, 73(1), 26–35.CrossRefGoogle Scholar
Bier, N., Provencher, V., Gagnon, L., Van der Linden, M., Adam, S., & Desrosiers, J. (2008). New learning in dementia: Transfer and spontaneous use of learning in everyday life functioning. Two case studies. Neuropsychological Rehabilitation, 18(2), 204–235.CrossRefGoogle ScholarPubMed
Brodaty, H., & Green, A. (2002). Defining the role of the caregiver in Alzheimer’s disease treatment. Drugs & Aging, 19(12), 891–898.CrossRefGoogle ScholarPubMed
Cahill, S., Macijauskiene, J., Nygård, A.-M., Faulkner, J.-P., & Hagen, I. (2007). Technology in dementia care. Technology and Disability, 19(2), 55–60.CrossRefGoogle Scholar
Camp, C. J. (1989). Facilitation of new learning in Alzheimer’s disease. In Gilmore, G., Whitehouse, P., & Wykle, M. (Eds.), Memory and Aging: Theory, Research and Practice (pp. 212–225). New York: Springer.Google Scholar
Camp, C. J., Bird, M. J., & Cherry, K. E. (2000). Retrieval strategies as a rehabilitation aid for cognitive loss in pathological aging. In Hill, R. D., Backman, L., & Stigsdotter-Neely, A. (Eds.). Cognitive Rehabilitation in Old Age (pp. 224–248). New York: Oxford University Press.Google Scholar
Camp, C. J., Foss, J. W., Stevens, A. B., & O’Hanlon, A. M. (1996). Improving prospective memory task performance in persons with Alzheimer’s disease.Google Scholar
Cavanagh, S. (1997). Content analysis: Concepts, methods and applications. Nurse Researcher, 4(3), 5–16.Google ScholarPubMed
Chagnon, F., & Gervais, M.-J. (2011). Modélisation du processus et des retombées de l'application des connaissances dans le domaine psychosocial : phase II. Fonds québéçois de recherche sur le société et la culture.Google Scholar
Cherry, K. E., Simmons, S. S., & Camp, C. J. (1999). Spaced retrieval enhances memory in older adults with probable Alzheimer’s disease. Journal of Clinical Geropsychology, 5(3), 159–175.CrossRefGoogle Scholar
Clare, L., & Jones, R. S. (2008). Errorless learning in the rehabilitation of memory impairment: A critical review. Neuropsychology Review, 18(1), 1–23.CrossRefGoogle ScholarPubMed
Col, N., Fanale, J. E., & Kronholm, P. (1990). The role of medication noncompliance and adverse drug reactions in hospitalizations of the elderly. Archives of Internal Medicine, 150(4), 841–845.CrossRefGoogle ScholarPubMed
Dabbs, A. D. V., Myers, B. A., Mc Curry, K. R., Dunbar-Jacob, J., Hawkins, R. P., Begey, A., & Dew, M. A. (2009). User-Centered design and interactive health technologies for patients. Computers, Informatics, Nursing, 27(3), 175.CrossRefGoogle Scholar
de Werd, M. M., Boelen, D., Rikkert, M. G. O., & Kessels, R. P. (2013). Errorless learning of everyday tasks in people with dementia. Clinical Interventions in Aging, 8, 1177–1190.Google ScholarPubMed
de Werd, M. M., Boelen, D., Rikkert, M. G. O., & Kessels, R. P. (2015). Development and evaluation of a clinical manual on errorless learning in people with dementia. Brain Impairment, 16(1), 52–63.CrossRefGoogle Scholar
Dijkers, M. P., Hart, T., Tsaousides, T., Whyte, J., & Zanca, J. M. (2014). Treatment taxonomy for rehabilitation: Past, present, and prospects. Archives of Physical Medicine and Rehabilitation, 95(1), S6–S16.CrossRefGoogle ScholarPubMed
Fontaine, F. (1996). Utilisation de la méthode d’apprentissage par estompage auprès de sujets avec des troubles mnésiques progressifs.Google Scholar
Fortinsky, R. H. (2001). Health care triads and dementia care: Integrative framework and future directions. Aging & Mental Health, 5(Suppl 1), S35–S48.CrossRefGoogle ScholarPubMed
Fuhrer, M. J. (2003). Overview of clinical trials in medical rehabilitation: Impetuses, challenges, and needed future directions. American Journal of Physical Medicine & Rehabilitation, 82(10), S8–S15.CrossRefGoogle ScholarPubMed
Gillespie, R., Mullan, J., & Harrison, L. (2014). Managing medications: The role of informal caregivers of older adults and people living with dementia. A review of the literature. Journal of Clinical Nursing, 23(23–24), 3296–3308.CrossRefGoogle ScholarPubMed
Glisky, E. L., Schacter, D. L., & Tulving, E. (1986). Learning and retention of computer-related vocabulary in memory-impaired patients: Method of vanishing cues. Journal of Clinical and Experimental Neuropsychology, 8(3), 292–312.CrossRefGoogle ScholarPubMed
Haskins, E. C., Cicerone, K. D., & Trexler, L. E. (2012). Cognitive rehabilitation manual: Translating evidence-based recommendations into practice. Reston, VA: ACRM Publications.Google Scholar
Hoffmann, T. C., Glasziou, P. P., Boutron, I., Milne, R., Perera, R., Moher, D., … Johnston, M. (2014). Better reporting of interventions: Template for intervention description and replication (TIDieR) checklist and guide. BMJ, 348, g1687.CrossRefGoogle ScholarPubMed
Hubbard, I. J., Harris, D., Kilkenny, M. F., Faux, S. G., Pollack, M. R., & Cadilhac, D. A. (2012). Adherence to clinical guidelines improves patient outcomes in Australian audit of stroke rehabilitation practice. Archives of Physical Medicine and Rehabilitation, 93(6), 965–971.CrossRefGoogle ScholarPubMed
Imbeault, H., Bier, N., Pigot, H., Gagnon, L., Marcotte, N., Fulop, T., & Giroux, S. (2013). Electronic organiser and Alzheimer’s disease: Fact or fiction? Neuropsychological Rehabilitation, 24(1), 71–100. doi: 10.1080/09602011.2013.858641 CrossRefGoogle ScholarPubMed
Kaasalainen, S., Dolovich, L., Papaioannou, A., Holbrook, A., Lau, E., Ploeg, J., … Emily, A. (2011). The process of medication management for older adults with dementia. Journal of Nursing and Healthcare of Chronic Illness, 3(4), 407–418.CrossRefGoogle Scholar
Kuzuya, M., Hirakawa, Y., Suzuki, Y., Iwata, M., Enoki, H., Hasegawa, J., & Iguchi, A. (2008). Association between unmet needs for medication support and all-cause hospitalization in community-dwelling disabled elderly people. Journal of the American Geriatrics Society, 56(5), 881–886.CrossRefGoogle ScholarPubMed
Lancioni, G. E., Singh, N. N., O’Reilly, M. F., Sigafoos, J., Pangrazio, M. T., Megna, M., … Minervini, M. G. (2009). Persons with moderate Alzheimer’s disease improve activities and mood via instruction technology. American Journal of Alzheimer’s Disease and Other Dementias, 24(3), 246–257.CrossRefGoogle ScholarPubMed
Laver, K., Cumming, R., Dyer, S., Agar, M., Anstey, K. J., Beattie, E., … Crotty, M. (2017). Evidence-based occupational therapy for people with dementia and their families: What clinical practice guidelines tell us and implications for practice. Australian Occupational Therapy Journal, 64(1), 3–10.CrossRefGoogle ScholarPubMed
Lekeu, F., Wojtasik, V., Van der Linden, M., & Salmon, E. (2002). Training early Alzheimer patients to use a mobile phone. Acta Neurologica Belgica, 102(3), 114–121.Google ScholarPubMed
Lenker, J. A., & Paquet, V. L. (2004). A new conceptual model for assistive technology outcomes research and practice. Assistive Technology, 16(1), 1–10.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer’s disease Report of the NINCDS-ADRDA Work Group* under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology, 34(7), 939–939.CrossRefGoogle ScholarPubMed
Mokhtari, M., Aloulou, H., Tiberghien, T., Biswas, J., Racoceanu, D., & Yap, P. (2012). New trends to support independence in persons with mild dementia–a mini-review. Gerontology, 58(6), 554–563.CrossRefGoogle ScholarPubMed
Molin, G., Pettersson, C., Jonsson, O., & Keijer, U. (2007). Living at home with acquired cognitive impairment–Can assistive technology help? Technology and Disability, 19(2), 91–101.CrossRefGoogle Scholar
O’Neill, S. A., Mason, S., Parente, G., Donnelly, M. P., Nugent, C. D., McClean, S., … Craig, D. (2011). Video reminders as cognitive prosthetics for people with dementia. Ageing International, 36(2), 267–282.CrossRefGoogle Scholar
Oriani, M., Moniz-Cook, E., Binetti, G., Zanieri, G., Frisoni, G., Geroldi, C., … Zanetti, O. (2003). An electronic memory aid to support prospective memory in patients in the early stages of Alzheimer’s disease: A pilot study. Aging & Mental Health, 7(1), 22–27.CrossRefGoogle ScholarPubMed
Paterson, M., Kinnear, M., Bond, C., & McKinstry, B. (2017). A systematic review of electronic multi-compartment medication devices with reminder systems for improving adherence to self-administered medications. International Journal of Pharmacy Practice, 25(3), 185–194.CrossRefGoogle ScholarPubMed
Perilli, V., Lancioni, G. E., Laporta, D., Paparella, A., Caffo, A. O., Singh, N. N., … Oliva, D. (2013). A computer-aided telephone system to enable five persons with Alzheimer’s disease to make phone calls independently. Research in Developmental Disabilities, 34(6), 1991–1997.CrossRefGoogle ScholarPubMed
Poland, F., Mapes, S., Pinnock, H., Katona, C., Sorensen, S., Fox, C., & Maidment, I. D. (2014). Perspectives of carers on medication management in dementia: Lessons from collaboratively developing a research proposal. BMC Research Notes, 7(1), 463.CrossRefGoogle ScholarPubMed
Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., … Hensley, M. (2011). Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health and Mental Health Services Research, 38(2), 65–76.CrossRefGoogle ScholarPubMed
Proctor, E. K., Powell, B. J., & McMillen, J. C. (2013). Implementation strategies: Recommendations for specifying and reporting. Implementation Science, 8(1), 139.CrossRefGoogle ScholarPubMed
Quittre, A., Adam, S., Olivier, C., & Salmon, E. (2009). Maladie d’Alzheimer précoce: Utilisation conjointe d’un agenda et d’un téléphone portable pour le maintien de l’orientation spatio-temporelle [Early Alzheimer’s disease: Concomitant use of an agenda and portable phone for maintaining spatio-temporal orientation]. In Adam, S., Allain, P., Aubin, G., & Coyette, F. (Eds.), Actualités en rééducation neuropsychologique: études de cas [New Developments in Neuropsychological Rehabilitation: Case Studies] (pp. 333–365). Marseille: Solal.Google Scholar
Robinson, L., Hutchings, D., Corner, L., Finch, T., Hughes, J., Brittain, K., & Bond, J. (2007). Balancing rights and risks: Conflicting perspectives in the management of wandering in dementia. Health, Risk & Society, 9(4), 389–406.CrossRefGoogle Scholar
Roger, K. S. (2008). Priorities for people living with dementia: Education, counseling, research. Clinical Interventions in Aging, 3(3), 573.Google Scholar
Rosenberg, L., Kottorp, A., & Nygård, L. (2012). Readiness for technology use with people with dementia the perspectives of significant others. Journal of Applied Gerontology, 31(4), 510–530.CrossRefGoogle Scholar
Rouleau, I., Imbeault, H., Denault, C., Briere, S., Laflamme, K., & Lefebvre, A.-A. (2006). Compensation des troubles de la mémoire prospective par l’utilisation du carnet de mémoire. Revue québécoise de psychologie, 27(3), 87–104.Google Scholar
Schulz, R., Wahl, H.-W, Matthews, J. T., De Vito Dabbs, A., Beach, S. R., & Czaja, S. J. (2015). Advancing the aging and technology agenda in gerontology. The Gerontologist, 55(5), 724–734.CrossRefGoogle ScholarPubMed
Smith, F., Francis, S. A., Gray, N., Denham, M., & Graffy, J. (2003). A multi-centre survey among informal carers who manage medication for older care recipients: Problems experienced and development of services. Health & Social Care in the Community, 11(2), 138–145.CrossRefGoogle ScholarPubMed
Sohlberg, M. M., & Mateer, C. A. (1989). Training use of compensatory memory books: A three stage behavioral approach. Journal of Clinical and Experimental Neuropsychology, 11(6), 871–891.CrossRefGoogle ScholarPubMed
Starkhammar, S., & Nygård, L. (2008). Using a timer device for the stove: Experiences of older adults with memory impairment or dementia and their families. Technology and Disability, 20(3), 179–191.CrossRefGoogle Scholar
Thivierge, S., Jean, L., & Simard, M. (2014). A randomized cross-over controlled study on cognitive rehabilitation of instrumental activities of daily living in Alzheimer disease. The American Journal of Geriatric Psychiatry, 22(11), 1188–1199.CrossRefGoogle Scholar
Thivierge, S., Simard, M., Jean, L., & Grandmaison, É. (2008). Errorless learning and spaced retrieval techniques to relearn instrumental activities of daily living in mild Alzheimer’s disease: A case report study. Neuropsychiatric Disease and Treatment, 4(5), 987.Google ScholarPubMed
Weintraub, S., Wicklund, A. H., & Salmon, D. P. (2012). The neuropsychological profile of Alzheimer disease. Cold Spring Harbor Perspectives in Medicine, 2(4), a006171.CrossRefGoogle ScholarPubMed
While, C., Duane, F., Beanland, C., & Koch, S. (2013). Medication management: The perspectives of people with dementia and family carers. Dementia, 12(6), 734–750.CrossRefGoogle ScholarPubMed
Wilson, B., Baddeley, A., Evans, J., & Shiel, A. (1994). Errorless learning in the rehabilitation of memory impaired people. An International Journal, 4(3), 307–326. doi: 10.1080/09602019408401463 Google Scholar