Effect of clinical pharmacists' interventions on dementia treatment adherence and caregivers' knowledge

F, Balli; Ünsal, Pelin; Halil, Meltem; Cankurtaran, Mustafa; Demirkan, Kutay

doi:10.1111/ggi.14170

Cited by 11 publications

(20 citation statements)

References 25 publications

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“…Overall, the results showed that 71% of the patients presented satisfactory treatment adherence, which is similar to other studies which measured adherence also through the patient's caregiver ( 27 , 28 ). In a multicenter, cross-sectional, observational study ( 27 ) found a 63% treatment adherence, although they evaluated the degree of adherence to transdermal vs .…”

Section: Discussionsupporting

confidence: 87%

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Role of caregivers on medication adherence management in polymedicated patients with Alzheimer's disease or other types of dementia

Muñoz-Contreras

Segarra

López-Román

et al. 2022

Front. Public Health

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BackgroundAlzheimer's disease (AD) and other dementia patients may have severe difficulties to ensure medication adherence due to their generally advanced age, polymedicated and multi-pathological situations as well as certain degree of cognitive impairment. Thus, the role of patient caregivers becomes crucial to warrantee treatment compliance.PurposeTo assess the factors associated to patients and caregivers on medication adherence of patients with AD and other types of dementia as well as the degree of caregiver satisfaction with respect to treatment.MethodsAn observational, descriptive, cross-sectional study among the caregivers of 100 patients with AD and other types of dementia of the “Cartagena and Region Association of Relatives of Patients with Alzheimer's Disease and other Neurodegenerative Diseases” was conducted to assess patient and caregiver factors that influence medication adherence evaluated with the Morisky-Green-Levine test.ResultsOverall, adherence to treatment was 71%, with similar proportions between male and female patients. Greater adherence was found in married or widowed patients (49.3%), first degree (85.9%) or female (81.7%) caregivers but lower in AD patients (75.9%). Multivariate analysis showed a statistically significant positive association between non-adherence and male sex of the caregiver (OR 3.512 [95%IC 1.124–10.973]), dementia (OR 3.065 [95%IC 1.019–9.219]), type of caregiver (non-first-degree relative) (OR 0.325 [95%IC 0.054–0.672]) and civil status of the patient (OR 2.011 [95%IC 1.155–3.501]) favorable for married or widowed patients. No or week association was found with gender, age, education level, number of drugs used or polymedicated status of the patient. Caregivers considered the use (90%) and administration (91%) of the treatment easy or very easy and rarely interfered with their daily life, especially for female caregivers (p = 0.016). Finally, 71% indicated that they were satisfied or very satisfied with the treatment received by the patient.ConclusionsCaregivers influence therapeutic management with predictors for improved adherence including female gender and first-degree kinship, together with patient's marital status. Thus, training caregivers about the disease and the importance of medication adherence in AD patients may ensure optimal treatment.

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Section: Discussionsupporting

confidence: 87%

“…oral formulation of rivastigmine, a different study goal from the current study but with similar values of adherence. Another similar study ( 28 ) observed a 70.2% degree of adherence to dementia drugs before and after a pharmaceutical intervention at a geriatric outpatient clinic of the university hospital.…”

Section: Discussionmentioning

confidence: 74%

Role of caregivers on medication adherence management in polymedicated patients with Alzheimer's disease or other types of dementia

Muñoz-Contreras

Segarra

López-Román

et al. 2022

Front. Public Health

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“…Factors affecting persistence and adherence include severity of dementia, education level, drug burden, economic status, and adverse drug reactions 11,13,18–24 . Whether different AD drugs affect treatment persistence or adherence varied among studies 12,25–27 . Caregiver support and knowledge of disease and medications are crucial for treatment adherence and efficacy 27–29 …”

Section: What Is Known and Objectivementioning

confidence: 99%

Effects of caregiver counselling on medication persistence and adherence in patients with dementia at a pharmacist‐managed clinic: A pilot study

Huang

et al. 2022

Clinical Pharmacy Therapeu

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What Is Known and Objective Low treatment persistence and adherence in patients with dementia results in a rapid loss of disease control. This pilot study evaluated the impact of pharmacist‐provided caregiver counselling on treatment persistence, adherence, quality of life (QoL) in patients with dementia, as well as caregiver's knowledge of dementia, and caregiver burden. Methods This prospective, randomized controlled study was performed at a hospital‐based pharmacist‐managed clinic from December 2017 to December 2019. Patients with mild‐to‐moderate Alzheimer's disease (AD), initiating cholinesterase inhibitors within 3 months, and coming with their caregivers were included and randomized 1:1 to intervention or control group. The intervention group received pharmacist counselling and education sheets about AD, whereas the control group only received standard of care. Patients' treatment persistence and adherence were assessed at months 3, 6, 9, and 12; QoL, and caregiver burden were assessed at baseline and month 12. Caregiver's knowledge of dementia was assessed at baseline and 2 weeks after counselling in the intervention group. Nonparametric statistics and generalized estimating equation models were used for statistical analysis. Results and Discussion A total of 40 patients and 40 caregivers were included, with 20 pairs for each group. One‐year medication persistence (16/20 vs. 16/20) and adherence rates (87%–99%) were high in both groups without significant differences. Dementia knowledge scores improved significantly after counselling in the intervention group (77.5 vs. 95.8, p < 0.01). Although the change of caregiver burden was non‐significant between groups, the score decreased in the intervention group (−0.89; p = 0.78) but increased in the control group (+6.01; p = 0.07). What Is New and Conclusion In this pilot study, pharmacist's counselling for patients with dementia and their caregivers is feasible and can enhance caregiver knowledge of dementia. Further study with larger scale is needed to confirm the impact on these outcomes.

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“…Initially, it has been validated on 290 hypertensive patients showing an adequate reliability and internal consistency (Cronbach alpha = 0.61). It has been later used for the detection of nonadherence in other several health conditions in both Arabic-and non-Arabic speaking contexts [5][6][7][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29].…”

Section: The Morisky Green and Levine (Mgl) Medication Adherence Scalementioning

confidence: 99%

“…While the other adherence scales developed by Prof. Morisky are copyrighted, the MGL scale is in the public domain and has been largely cited in the last decade in several research studies, including studies from the MENA region and Jordan [5][6][7][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Translation and validation of the Arabic version of the Morisky, Green and Levine (MGL) adherence scale

et al. 2022

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The Morisky Green Levine (MGL) adherence scale is a 4-item tool used for the detection of medication nonadherence among patients with chronic health conditions. Despite being widely used in Arabic-speaking research contexts, it has never been validated in Arabic language. The aim of this study was to translate and validate the MGL tool into Arabic. A standard forward-backward process was used to translate the questionnaire. Cronbach’s alpha coefficient was measured to assess internal consistency of the scale. The test-retest reliability measured the consistency of participants’ responses over time. Construct validity was evaluated by Explanatory factor analysis (EFA); Kaiser-Meyer-Olkin value and Bartlett’s test of sphericity were determined. Convergent validity was assessed using a preexisting medications Arabic Adherence Assessment Tool (AAAT). The model fit was evaluated using confirmatory factor analysis (CFA). Associations between the MGL scale scores and the patient demographic/clinical characteristics were tested by linear regressions. A total of 201 participants were included into the study. The MGL scale categorization revealed that 20.9%, 59.2% and 19.9% of the participants had high, moderate and low levels of adherence respectively. Adequate internal consistency (alpha = 0.593) was observed. A significant strong ICC and Pearson’s correlations were generated between responses at time 1 and time 2. EFA results elucidated the suitability of the data for factor analysis. Pearson’s coefficient (r) revealed a significant strong correlation between MGL scale and AAAT. CFA results confirmed a good fit for the suggested model. Linear regression revealed higher number of medications, more frequent outpatient clinic visits and not experiencing medication adverse effect factors significantly associated with better adherence. The Arabic version of MLG scale is a reliable valid tool to assess adherence among Arabic-speaking communities. Implementing interventions targeting patients not compliant to regular clinic visits and those at higher risk of experiencing medication side effects can greatly enhance medication adherence.

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Effect of clinical pharmacists' interventions on dementia treatment adherence and caregivers' knowledge

Cited by 11 publications

References 25 publications

Role of caregivers on medication adherence management in polymedicated patients with Alzheimer's disease or other types of dementia

Role of caregivers on medication adherence management in polymedicated patients with Alzheimer's disease or other types of dementia

Effects of caregiver counselling on medication persistence and adherence in patients with dementia at a pharmacist‐managed clinic: A pilot study

Translation and validation of the Arabic version of the Morisky, Green and Levine (MGL) adherence scale

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