Development of a tool to evaluate medication management guidance provided to carers of people living with dementia at hospital discharge: a mixed methods study

Abstract

ObjectiveMedication management guidance for carers of people with dementia at hospital discharge is important to prevent medication-related harm during transitions of care. This study aimed to develop a tool to evaluate medication management guidance provided to carers of people with dementia at hospital discharge.DesignThe tool was developed using mixed methods involving two stages. Stage 1 involved item generation and content validation. Items were based on a previous qualitative study and systematic review. Content validation involved experts and consumers with knowledge or experience of medication management guidance in the acute care setting, and rating each item on importance and relevance. Stage 2 involved conducting cognitive interviews with carers of people with dementia to pretest the tool.SettingFor stage 1, experts and consumers from Australia, USA and New Zealand were included. For stage 2, carers of people with dementia were recruited across Australia.Participants18 experts and consumers participated in round 1 of content validation, and 13 experts and consumers completed round 2. Five carers of people with dementia participated in cognitive interviews.ResultsThe final tool contained 30 items capturing information across five domains: (1) provision of medication management guidance at hospital discharge; (2) carer understanding of medication management guidance provided at discharge; (3) carer engagement in discussing the safe use of medications at discharge; (4) carer preparedness to conduct medication management activities after discharge; and (5) co-ordination of medication management guidance after discharge.ConclusionsWe developed the first tool to assess medication management guidance provided for carers of people with dementia at hospital discharge. The tool may be useful to inform future research strategies to improve the delivery of medication management guidance at discharge.

The Carer Assessment of MedicaTion Management GuidanCe for People With Dementia at Hospital Discharge (CATCH) Tool

“…Twenty-five items formed part of the CATCH tool, and 3 of these items were considered as outcomes due to their relevance in highlighting carers preparedness to conduct medication management activities after discharge (ie, carers’ feelings of satisfaction, confidence, and being overwhelmed at discharge). The development of this tool has been detailed in previous literature 18 . Therefore, as part of the scale development process, 22 items were subject to exploratory factor analysis (EFA).…”

“…The development of this tool has been detailed in previous literature. 18 Therefore, as part of the scale development process, 22 items were subject to exploratory factor analysis (EFA). The CATCH tool contained Likert scale items on a 5-point scale that covered: carer understanding of the guidance provided at discharge and carer engagement in discussing the safe use of medications at discharge (Supplemental Digital Content A, Supplemental Digital Content 1, http://links.lww.com/ WAD/A475).…”

“…However, it is not yet clear how the guidance provided to caregivers at discharge affects their confidence in managing medication and their sense of being overwhelmed during care transitions. To address this gap, we developed the Carer Assessment of medicaTion management guidanCe for people with dementia at Hospital discharge (CATCH) tool 18 . Content validation and cognitive interviews with carers were used to develop the CATCH tool 18 .…”

“…To address this gap, we developed the Carer Assessment of medicaTion management guidanCe for people with dementia at Hospital discharge (CATCH) tool 18 . Content validation and cognitive interviews with carers were used to develop the CATCH tool 18 . The next step of tool development involved exploring the factor structure of the CATCH tool to reveal the underlying factors and determine how they relate to carer preparedness to manage medications at discharge.…”

“…18 Content validation and cognitive interviews with carers were used to develop the CATCH tool. 18 The next step of tool development involved exploring the factor structure of the CATCH tool to reveal the underlying factors and determine how they relate to carer preparedness to manage medications at discharge. The objectives of this study were to (1) explore the underlying factors of the CATCH tool to provide preliminary validation of the tool; (2) characterize carers' experiences of medication management guidance for people with dementia at discharge in Australia using the CATCH tool, and (3) to identify predictors of carer preparedness to manage medications at discharge.…”