Alzheimer Europe Conference
PO1.3 BREGOLA Allan - Does carer management style predict functional performance in medication management in Alzheimer’s
PO1.3. Does carer management style predict functional performance in medication management in Alzheimer’s disease?
BREGOLA Allan, TRUCCO Ana Paula, CAMINO Julieta, MIOSHI Eneida
Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
Background: A comprehensive approach comprising good communication, assistive technology (AT) and supportive carer styles seems to benefit functional performance. Less is known about such approach in medication management.
Aim: To explore association of carer management styles with medication management, considering use of AT, number of medications and global cognition.
Methods: Cross-sectional analyses; 99 people with Alzheimer’s disease (PwAD) and family carers. Dementia Management Strategies Scale (DMSS) identified primary carer style: Criticism(CS), Encouragement(ES), Active Management(AMS). Disability Assessment for Dementia (DAD) assessed Initiation and Effective Performance of medication management. Covariates included: use of AT (medication reminders/dispensers), number of medications, global cognition (Addenbrooke’s Cognitive Examination-ACE-III: scores 0-100). Two binary regressions models (Criticism style as reference category) investigated if ES and AMS (independent variables) were associated with dependency in Initiation (dependent variable, model 1) and Effective Performance (dependent variable, model 2) of medication management. Covariates were AT use, number of medications, global cognition.
Results: 32% of carers adopted ES; 25.8% AMS. CS was adopted by most (42.2%). PwAD age was 78.4±6.6y; 60% male; similar proportions (71%) were dependent in Initiation and Effective Performance of medication management; one quarter (25.3%) used medication reminders/dispensers; average number of medications taken was 4.6±3.3; ACE-III was 55.8±21.2. Carer ES was associated with PwAD’s Initiation of medication management (OR=4.11; 95%CI: 1.31-12.85; p=0.01); no association was found with Effective Performance. ES was marginally associated with Initiation when analysis was controlled by the three covariates (OR=3.45; 95%CI: 0.99-12.05; p=.05). No statistical significance was found between AMS or CS in Initiation or Effective Performance.
Conclusion: Carer Encouragement style seems to support Initiation of medication management to an extent, possibly by overcoming PwAD’s apathy. However, when great number of medications, AT use and severe cognitive deficits are part of the context, carer encouragement alone does not seem to be enough to support functional deficits.
PO1.3 BREGOLA Allan - Does carer management style predict functional performance in medication management in Alzheimer’s
PO1.3. Does carer management style predict functional performance in medication management in Alzheimer’s disease?
BREGOLA Allan, TRUCCO Ana Paula, CAMINO Julieta, MIOSHI Eneida
Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
Background: A comprehensive approach comprising good communication, assistive technology (AT) and supportive carer styles seems to benefit functional performance. Less is known about such approach in medication management.
Aim: To explore association of carer management styles with medication management, considering use of AT, number of medications and global cognition.
Methods: Cross-sectional analyses; 99 people with Alzheimer’s disease (PwAD) and family carers. Dementia Management Strategies Scale (DMSS) identified primary carer style: Criticism(CS), Encouragement(ES), Active Management(AMS). Disability Assessment for Dementia (DAD) assessed Initiation and Effective Performance of medication management. Covariates included: use of AT (medication reminders/dispensers), number of medications, global cognition (Addenbrooke’s Cognitive Examination-ACE-III: scores 0-100). Two binary regressions models (Criticism style as reference category) investigated if ES and AMS (independent variables) were associated with dependency in Initiation (dependent variable, model 1) and Effective Performance (dependent variable, model 2) of medication management. Covariates were AT use, number of medications, global cognition.
Results: 32% of carers adopted ES; 25.8% AMS. CS was adopted by most (42.2%). PwAD age was 78.4±6.6y; 60% male; similar proportions (71%) were dependent in Initiation and Effective Performance of medication management; one quarter (25.3%) used medication reminders/dispensers; average number of medications taken was 4.6±3.3; ACE-III was 55.8±21.2. Carer ES was associated with PwAD’s Initiation of medication management (OR=4.11; 95%CI: 1.31-12.85; p=0.01); no association was found with Effective Performance. ES was marginally associated with Initiation when analysis was controlled by the three covariates (OR=3.45; 95%CI: 0.99-12.05; p=.05). No statistical significance was found between AMS or CS in Initiation or Effective Performance.
Conclusion: Carer Encouragement style seems to support Initiation of medication management to an extent, possibly by overcoming PwAD’s apathy. However, when great number of medications, AT use and severe cognitive deficits are part of the context, carer encouragement alone does not seem to be enough to support functional deficits.