The impact of family caregivers on potentially inappropriate medication use in noninstitutionalized older adults with dementia.
BACKGROUND
The risk of potentially inappropriate medication (PIM), both prescription and over-the-counter, use in dementia patients is high. Informal caregivers often facilitate patients' use of medications, but the effect of caregiver factors on PIM use has not been a focus of previous research.


OBJECTIVE
The aim of this study was to examine PIM use in dementia patients and caregivers and identify caregiver risk factors for PIM use in dementia patients.


METHODS
We conducted a secondary data analysis of the baseline wave of the Resources for Enhancing Alzheimer's Caregiver's Health study. The sample comprised 566 persons with dementia aged 65 and older and their coresiding family caregiver. PIM was defined using the 2003 Beers criteria and was examined in both dementia patients and their caregivers. Caregiver and patient risk factors included a range of sociodemographic and health variables.


RESULTS
In dementia patients, 33% were taking at least 1 PIM, and 39% of their caregivers were also taking a PIM. In fully adjusted models, the following caregiver factors were associated with an increased risk of dementia patient PIM use: caregiver's own PIM use, spouse caregivers, Hispanic caregivers, and greater number of years that the caregiver has lived in the United States. Increased caregiver age was associated with a decreased risk of PIM use in patients.


CONCLUSIONS
PIM use may be higher in dementia patients and their informal caregivers compared with the general older adult population. Further, patterns of medication use in 1 member of the dyad may influence PIM risk in the other dyad member. These results suggest that interventions to increase appropriate medication use in dementia patients and their caregivers should target both members of the dyad and target over-the-counter agents along with prescription medications.
VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA. jmthorpe@pitt.edu
Joshua M
JM
Thorpe
Carolyn T
CT
Thorpe
Korey A
KA
Kennelty
Walid F
WF
Gellad
Richard
R
Schulz
D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology; D003704:Dementia / Q000208:ethnology / Q000523:psychology / Q000628:therapy*; D054242:Emigrants and Immigrants / Q000523:psychology; D005190:Family / Q000208:ethnology / Q000523:psychology; D005191:Family Characteristics / Q000208:ethnology; D005192:Family Health / Q000208:ethnology; D005260:Female; D015577:Geriatric Assessment; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control / Q000523:psychology; D004366:Nonprescription Drugs / Q000008:administration & dosage / Q000627:therapeutic use; D055553:Prescription Drugs / Q000008:administration & dosage / Q000627:therapeutic use; D018454:Spouses / Q000523:psychology; D014481:United States
D004366:Nonprescription Drugs; D055553:Prescription Drugs