Enhancing medicines self-management in community-dwelling people living with dementia and family carers: an intervention development and feasibility study
Award Number
NIHR203593Programme
Research for Patient BenefitStatus / Stage
CompletedDates
20 March 2023 -12 June 2023
Duration (calculated)
00 years 02 monthsFunder(s)
NIHRFunding Amount
£249,900.00Funder/Grant study page
NIHRContracted Centre
Bradford Teaching Hospitals NHS Foundation TrustPrincipal Investigator
Dr Beth FylanPI Contact
b.fylan@bradford.ac.ukPI ORCID
0000-0003-0599-4537Principal Investigator
Dr Catherine PowellPI ORCID
0000-0001-7590-0247WHO Catergories
Methodologies and approaches for risk reduction researchModels across the continuum of care
Disease Type
Mild DementiaModerate Dementia
CPEC Review Info
| Reference ID | 209 |
|---|---|
| Researcher | Reside Team |
| Published | 12/06/2023 |
Data
| Award Number | NIHR203593 |
|---|---|
| Status / Stage | Completed |
| Start Date | 20230320 |
| End Date | 20230612 |
| Duration (calculated) | 00 years 02 months |
| Funder/Grant study page | NIHR |
| Contracted Centre | Bradford Teaching Hospitals NHS Foundation Trust |
| Funding Amount | £249,900.00 |
Abstract
How can community dwelling people with mild-moderate dementia with and without family carers be supported to safely self-manage medicines? Background Within the UK, approximately 850,000 live with dementia (Prince et al., 2014). Many people with dementia are at risk of medication-related adverse events (Lim and Sharmeen, 2018). Our systematic review identified psychosocial interventions as a promising solution for enhancing medicines self-management for people with mild-moderate dementia. Aims and Objectives We aim to explore and improve how people with mild-moderate dementia with and without their family carers self-manage medicines using the theory of resilience in healthcare; co-design an intervention for people living with mild-moderate dementia with and without their family carers to safely self-manage their medicines; and assess the feasibility of the co-designed community-based psychosocial intervention. Our research objectives are i) identify who is involved and healthcare resource use in the medicines self-management system for people with mild-moderate dementia with and without their family carers; ii) identify the medicine self-management strategies used or needed by people with mild-moderate dementia with and without family carers; iii) explore contextual factors and mechanisms underpinning medicines self-management; iv) co-design an intervention with people living with mild-moderate dementia, family carers and health and social care professionals to support medicine self-management strategies; v) develop a theory of change to support the co-designed intervention; vi) assess the feasibility and acceptability of implementing the co-designed intervention for people living with mild-moderate dementia, family carers and community-based health and social care professionals in preparation for a randomised controlled trial; vii) develop materials for estimating the healthcare resource use of participants, the costs of the intervention and the subsequent resource in both arms of an randomised controlled trial; viii) assess the feasibility of collecting a range of cost-effectiveness outcome measures. Methods We will use a mixed-methods approach, underpinned by resilience in healthcare theory. Phase one will involve qualitative interviews, verbal or written accounts, photos, and healthcare resource data, with 24 people with mild-moderate dementia with and without family carers; and 18 health/social care professionals interviews. Phase two comprises an adapted experienced based co-design of an intervention with staff and patients. In phase three we will test intervention feasibility with 72 people with mild-moderate dementia with and without family carers, who will be observed and complete questionnaires including: Medication Management Instrument for Deficiencies in the Elderly (MedMaIDE) (Orwig et al., 2006), the generalised self-efficacy scale (Schwarzer and Jerusalem 1995), EQ-5D-5L (Herdman et al., 2011), DEMQOL, DEMQOL proxy (Mulhern et al., 2013), Carer Experience Scale (CES) (Al-Janabi et al., 2011), and healthcare resource use. 20 will be interviewed and 3 staff delivering the intervention. Timelines for delivery Key project milestones include: Phase one, exploring medicine self-management strategies (end month 6); Phase 2 co-design the intervention (end month 15) and Phase 3 pre-test, post-test feasibility study (end month 24). Anticipated Impact and Dissemination Outputs will include an intervention, implementation guidance and a randomised controlled trial proposal. We will produce journal articles and conference presentations. Our co-design film will offer insight and training.
Aims
We aim to explore and improve how people with mild-moderate dementia with and without their family carers self-manage medicines using the theory of resilience in healthcare; co-design an intervention for people living with mild-moderate dementia with and without their family carers to safely self-manage their medicines; and assess the feasibility of the co-designed community-based psychosocial intervention. Our research objectives are i) identify who is involved and healthcare resource use in the medicines self-management system for people with mild-moderate dementia with and without their family carers; ii) identify the medicine self-management strategies used or needed by people with mild-moderate dementia with and without family carers; iii) explore contextual factors and mechanisms underpinning medicines self-management; iv) co-design an intervention with people living with mild-moderate dementia, family carers and health and social care professionals to support medicine self-management strategies; v) develop a theory of change to support the co-designed intervention; vi) assess the feasibility and acceptability of implementing the co-designed intervention for people living with mild-moderate dementia, family carers and community-based health and social care professionals in preparation for a randomised controlled trial; vii) develop materials for estimating the healthcare resource use of participants, the costs of the intervention and the subsequent resource in both arms of an randomised controlled trial; viii) assess the feasibility of collecting a range of cost-effectiveness outcome measures.