- Email: [email protected]
CAN TIMELY PROVISION OF INFORMATION INCREASE CARER CONFIDENCE AND IMPROVE THE CARER EXPERIENCE?
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P3-327
Poster Presentations: Tuesday, July 26, 2016
CAN TIMELY PROVISION OF INFORMATION INCREASE CARER CONFIDENCE AND IMPROVE THE CARER EXPERIENCE?
Zoe Campbell1, Colin Capper2, 1Alzheimer’s Society (UK), London, United Kingdom; 2Alzheimer’s Society, London, United Kingdom. Contact e-mail: [email protected] CrISP consists of two specific courses: CriSP 1: designed specifically for carers, family members and friends of people with a recent diagnosis of a dementia. It consists of four essential sessions: Understanding dementia, Legal and money matters, Providing support and care, Coping day-to-day and next steps. CrISP 2: has been designed specifically for people who have been living with dementia for some time. It consists of three essential sessions: Understanding how dementia progresses, Living with change as dementia progresses and Living well as dementia progresses, including occupation and activities. The Intended outcomes are; carers feel they have increased knowledge of dementia, carers feel they have been supported to access help and services, carers feel they have been provided with practical information they can use in coping with living with dementia, carers feel that they have received information and an understanding of how to plan with and for the person they care for, now and in the future, carers feel they have benefited from peer support and sharing experiences and carers are provided with access to a forum where information is given in an understandable format. Evaluation Assessed carer responses to the four-session programme and whether the outcomes of the programme were met. Three sets of questionnaires were completed by carers. The results and feedback at the end of the four session programme and from the ‘three months later’ questionnaires indicate that CrISP contributes markedly in meeting the needs of carers and the outcomes continue to benefit the carers beyond the end of the programme. The six outcomes of the Programme were met, indicating that carers benefited from the sessions. P3-328
MANAGING YOUR LOVED ONE’S HEALTH: DEVELOPMENT OF A NEW CARE MANAGEMENT MEASURE FOR DEMENTIA FAMILY CAREGIVERS
Tatiana Sadak, Soo Borson, University of Washington, Seattle, WA, USA. Contact e-mail: [email protected] Purpose: The National Alzheimer’s Plan calls for improving the
healthcare of individuals living with dementia and supporting their caregivers as capable health care partners. Family members and friends implement health care plans for dementia patients at home, but often do so at the expense of their own health, and without explicit training or support from clinicians. Clinically useful tools are needed to assess and monitor caregivers’ readiness, knowledge, and skills for managing the often-complex health care needs of individuals with dementia and simultaneous, sustained self-care. We created and validated a comprehensive, caregiver-centered measure, Managing Your Loved One’s Health (MYLOH). In this paper, we describe its development and preliminary cultural tailoring. Methods: We utilized a rigorous multi-phase instrument development method consisting of literature review, Iterative concept elicitation interviews with experts (N¼16) and caregivers (N¼35), cognitive interview focus groups with experts (N¼5) and caregivers (N¼15), psychometric validation with caregivers (N¼130), and tailoring for cultural equivalence of the resulting instrument with African American (N¼26) and Hispanic (N¼14) caregivers. Results: Expert providers and family caregivers
endorsed a core set of domains related to the healthcare management of care recipients with dementia and to personal self-care. The resulting measure, MYLOH, is a questionnaire containing 29 items (21 knowledge and 8 skills) grouped into 6 domains, rated using a 5-level response scale ranging from (1) ‘Disagree Completely’ to (4) ‘Agree Completely’ and (0), ‘Not my responsibility.’ Scores can range from 0-116, with lower scores suggesting the need for caregiver coaching. MYLOH has a 6th grade reading level and requires less than 20 minutes to complete when administered as paper and pencil caregiver self-report. This questionnaire is valid and reliable and appears to be relevant to both clinicians and ethnoculturally diverse caregivers. Implications: MYLOH is a suitable instrument for testing in a variety of settings. It can be used as a guide for conversations between clinicians and caregivers around health care management of people living with dementia and attending to their own self-care, as the basis for targeted health care coaching, and as an outcome measure in comprehensive dementia care management interventions. P3-329
PHARMACIST-MANAGED MEDICATION REVIEW IN A NOVEL MULTIDISCIPLINARY CARE MODEL FOR ELDERLY WITH DEMENTIA
Yee Ling Wong, Ka Lung Cheung, Chun Chung Chan, Cho Yiu Yung, United Christian Hospital, Hong Kong, Hong Kong. Contact e-mail: [email protected] Background: While cholinersterase inhibitors (ChEIs) in Alz-
heimer’s disease patients may delay disease progression, unrealistic expectations and adverse drug reactions (ADRs) lead to premature discontinuation of ChEIs (Roseanna et al, 2013). Drug-related problems (DRPs), including polypharmacy and inappropriate use of anticholinergics and antipsychotics, predispose dementia patients to ADRs and drug-interactions. Dementia patients usually require carers, who may not be familiar with patients’ conditions, for medication management. To better address issues concerning medication use in dementia patients, clinical pharmacists participate in a multidisciplinary Integrated Cognitive Assessment Clinic in an acute regional hospital in Hong Kong to provide medication review and consultation. Methods: Upon referral, pharmacists review current medications with focus on drugs relevant to dementia care. Pharmacists then provide face-to-face consultation to patients and carers to educate on anti-dementia medications and to screen for DRPs. Advices to minimise ADRs and drug-interactions are provided accordingly. Pharmacists inform physicians on DRP identified with recommendation on optimising drug regimen when appropriate. Phone follow-up is conducted at week 1, 2 and 4 after each patient visit to screen for ADRs with dose titration or therapeutic switch and further DRPs. Results: From November 2015 to January 2016, pharmacists provided 65 consultations and 138 phone follow-ups for 54 patients. Reasons for referral included initiation (30.8%), switching (9.2%), or dose titration of ChEIs (36.9%), and changes in dementia-related medications (23.1%). Eleven DRPs were identified, which includes miss dose (n¼4), incorrect administration (n¼3), complex drug regimen (n¼2), side effects of concurrent medications (n¼1) and wrong administration time (n¼1). Twenty-four ADRs were possibly related to ChEIs, of which eighteen were resolved with established management protocol. Six patients required dose reduction, discontinuation or therapeutic switch. Ten patients were prescribed with antipsychotics for behavioural and psychological symptoms of dementia that caused significant carer stress, which were considered appropriate. Pharmacists educated carers on proper antipsychotic dose titration per patients’ symptoms
P3-327
Poster Presentations: Tuesday, July 26, 2016
CAN TIMELY PROVISION OF INFORMATION INCREASE CARER CONFIDENCE AND IMPROVE THE CARER EXPERIENCE?
Zoe Campbell1, Colin Capper2, 1Alzheimer’s Society (UK), London, United Kingdom; 2Alzheimer’s Society, London, United Kingdom. Contact e-mail: [email protected] CrISP consists of two specific courses: CriSP 1: designed specifically for carers, family members and friends of people with a recent diagnosis of a dementia. It consists of four essential sessions: Understanding dementia, Legal and money matters, Providing support and care, Coping day-to-day and next steps. CrISP 2: has been designed specifically for people who have been living with dementia for some time. It consists of three essential sessions: Understanding how dementia progresses, Living with change as dementia progresses and Living well as dementia progresses, including occupation and activities. The Intended outcomes are; carers feel they have increased knowledge of dementia, carers feel they have been supported to access help and services, carers feel they have been provided with practical information they can use in coping with living with dementia, carers feel that they have received information and an understanding of how to plan with and for the person they care for, now and in the future, carers feel they have benefited from peer support and sharing experiences and carers are provided with access to a forum where information is given in an understandable format. Evaluation Assessed carer responses to the four-session programme and whether the outcomes of the programme were met. Three sets of questionnaires were completed by carers. The results and feedback at the end of the four session programme and from the ‘three months later’ questionnaires indicate that CrISP contributes markedly in meeting the needs of carers and the outcomes continue to benefit the carers beyond the end of the programme. The six outcomes of the Programme were met, indicating that carers benefited from the sessions. P3-328
MANAGING YOUR LOVED ONE’S HEALTH: DEVELOPMENT OF A NEW CARE MANAGEMENT MEASURE FOR DEMENTIA FAMILY CAREGIVERS
Tatiana Sadak, Soo Borson, University of Washington, Seattle, WA, USA. Contact e-mail: [email protected] Purpose: The National Alzheimer’s Plan calls for improving the
healthcare of individuals living with dementia and supporting their caregivers as capable health care partners. Family members and friends implement health care plans for dementia patients at home, but often do so at the expense of their own health, and without explicit training or support from clinicians. Clinically useful tools are needed to assess and monitor caregivers’ readiness, knowledge, and skills for managing the often-complex health care needs of individuals with dementia and simultaneous, sustained self-care. We created and validated a comprehensive, caregiver-centered measure, Managing Your Loved One’s Health (MYLOH). In this paper, we describe its development and preliminary cultural tailoring. Methods: We utilized a rigorous multi-phase instrument development method consisting of literature review, Iterative concept elicitation interviews with experts (N¼16) and caregivers (N¼35), cognitive interview focus groups with experts (N¼5) and caregivers (N¼15), psychometric validation with caregivers (N¼130), and tailoring for cultural equivalence of the resulting instrument with African American (N¼26) and Hispanic (N¼14) caregivers. Results: Expert providers and family caregivers
endorsed a core set of domains related to the healthcare management of care recipients with dementia and to personal self-care. The resulting measure, MYLOH, is a questionnaire containing 29 items (21 knowledge and 8 skills) grouped into 6 domains, rated using a 5-level response scale ranging from (1) ‘Disagree Completely’ to (4) ‘Agree Completely’ and (0), ‘Not my responsibility.’ Scores can range from 0-116, with lower scores suggesting the need for caregiver coaching. MYLOH has a 6th grade reading level and requires less than 20 minutes to complete when administered as paper and pencil caregiver self-report. This questionnaire is valid and reliable and appears to be relevant to both clinicians and ethnoculturally diverse caregivers. Implications: MYLOH is a suitable instrument for testing in a variety of settings. It can be used as a guide for conversations between clinicians and caregivers around health care management of people living with dementia and attending to their own self-care, as the basis for targeted health care coaching, and as an outcome measure in comprehensive dementia care management interventions. P3-329
PHARMACIST-MANAGED MEDICATION REVIEW IN A NOVEL MULTIDISCIPLINARY CARE MODEL FOR ELDERLY WITH DEMENTIA
Yee Ling Wong, Ka Lung Cheung, Chun Chung Chan, Cho Yiu Yung, United Christian Hospital, Hong Kong, Hong Kong. Contact e-mail: [email protected] Background: While cholinersterase inhibitors (ChEIs) in Alz-
heimer’s disease patients may delay disease progression, unrealistic expectations and adverse drug reactions (ADRs) lead to premature discontinuation of ChEIs (Roseanna et al, 2013). Drug-related problems (DRPs), including polypharmacy and inappropriate use of anticholinergics and antipsychotics, predispose dementia patients to ADRs and drug-interactions. Dementia patients usually require carers, who may not be familiar with patients’ conditions, for medication management. To better address issues concerning medication use in dementia patients, clinical pharmacists participate in a multidisciplinary Integrated Cognitive Assessment Clinic in an acute regional hospital in Hong Kong to provide medication review and consultation. Methods: Upon referral, pharmacists review current medications with focus on drugs relevant to dementia care. Pharmacists then provide face-to-face consultation to patients and carers to educate on anti-dementia medications and to screen for DRPs. Advices to minimise ADRs and drug-interactions are provided accordingly. Pharmacists inform physicians on DRP identified with recommendation on optimising drug regimen when appropriate. Phone follow-up is conducted at week 1, 2 and 4 after each patient visit to screen for ADRs with dose titration or therapeutic switch and further DRPs. Results: From November 2015 to January 2016, pharmacists provided 65 consultations and 138 phone follow-ups for 54 patients. Reasons for referral included initiation (30.8%), switching (9.2%), or dose titration of ChEIs (36.9%), and changes in dementia-related medications (23.1%). Eleven DRPs were identified, which includes miss dose (n¼4), incorrect administration (n¼3), complex drug regimen (n¼2), side effects of concurrent medications (n¼1) and wrong administration time (n¼1). Twenty-four ADRs were possibly related to ChEIs, of which eighteen were resolved with established management protocol. Six patients required dose reduction, discontinuation or therapeutic switch. Ten patients were prescribed with antipsychotics for behavioural and psychological symptoms of dementia that caused significant carer stress, which were considered appropriate. Pharmacists educated carers on proper antipsychotic dose titration per patients’ symptoms