Interventions at Hospital Discharge to Guide Caregivers in Medication Management for People Living with Dementia: A Systematic Review

Authors
Mouna J. Sawan
Damian Wennekers
Marissa Sakiris
Danijela Gnjidic
Peer-Reviewed Article
February 2021

Headline

Some medication management interventions that support caregivers of people with dementia at care transitions can help reduce readmissions, caregiver burden, and use of high-risk medication.

Context

People with dementia frequently are prescribed multiple medications and experience preventable medication-related hospital admissions. Informal caregivers for people with dementia must deal with the complexities of not only administering medications, but also communicating with health care providers and the care recipient. This systematic literature review synthesizes findings from five international studies on medication management interventions at hospital discharge for caregivers of people living with dementia.

Findings

While there is limited research on the impact of these medication management discharge interventions, some of the interventions showed positive outcomes. A pre-discharge caregiver intervention showed reduced length of stay, a post-discharge intervention with follow-up visits led to reduced readmissions and lower use of high-risk medications, and a post-discharge caregiver education program lessened caregiver burden. Notably, two other studies of discharge interventions related to medication management reported no statistically significant change in readmission rates. The only study that reported reduced readmissions used a comprehensive medication review including simplification of the medical regimen, which can reduce inappropriate use of medications.

Takeaways

While there is limited evidence on the impact of medication management interventions at discharge for caregivers of people with dementia, multidisciplinary interventions with specific characteristics  such as post-discharge components, effective communication, and caregiver guidance  can better support caregivers.

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Level of Evidence
Moderate
What does this mean?