Family caregivers’ facilitation of daily adult prescription medication use

• Published in: Patient education and counseling Vol. 101; no. 5; pp. 908 - 916
• Main Authors: Roter, Debra L., Narayanan, Siva, Smith, Katherine, Bullman, Ray, Rausch, Paula, Wolff, Jennifer L., Alexander, G. Caleb
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.05.2018
• Subjects: Adult; Aged; Caregivers; Communication; Cross-Sectional Studies; Family; Female; Home Nursing; Humans; Internet; Male; Medication Adherence; Medication communication; Medication Therapy Management; Middle Aged; Nursing; Pharmacists; Polypharmacy; Practical adherence support; Prescription Drugs - administration & dosage; Medication adherence; Medication communication; Practical adherence support
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2017.12.018

•Caregivers facilitate safe medication use at home, during medical visits and at the pharmacy.•Home medication management strategies are routinely used on behalf of patients.•Caregivers facilitate medical visit and pharmacist communication. To describe ways family members assist adult patients with prescription medications at home, during medical visits and at the pharmacy. Online survey of 400 adults (caregivers) who help another adult (care recipient) with prescription medication use. Regression modeled the contribution of caregiver communication during recipients’ medical visits, evaluation of physicians’ medication communication and discussions with the dispensing pharmacist on caregivers’ assistance with home medication management. Female (68%) family members (94%) assisted care recipients with multimorbidity (mean 2.9 conditions) and polypharmacy (mean 3.2 prescriptions). On average, caregivers performed 3 visit communication behaviors (e.g., notetaking) and implemented 2.6 home medication management strategies (e.g., filling/monitoring pill boxes). Communication-related variables explained 17% of home medication management assistance; including caregivers' visit communication (std. beta 0.31), physicians’ medication communication (std. beta 0.15) and pharmacist discussions (std. beta 0.10). The final model included recipients’ multimorbidity and caregiver education (std. betas 0.21 and 0.13) explaining 22% of caregiver assistance with home medication management. Caregivers' assistance with safe and effective home medication use crosses care contexts and is facilitated by clinician and pharmacist communication. Support for caregiver engagement in healthcare conversations can contribute to patient adherence and family-centered, high quality care.