Family caregivers’ perspectives on medication adherence challenges in older people with dementia: a qualitative study

Abstract

Objectives: To achieve a better understanding of medication non-adherence determinants in older people with dementia from caregivers’ perspectives and possible management solutions to improve medication adherence.

Method: Semi-structured telephone interviews were conducted with 20 caregivers of older people with dementia living in the community. Data was analyzed using an inductive thematic analysis based on Braun and Clarke’s method.

Findings: Four themes emerged: dementia symptoms influence medication adherence, medication increases caregiver burden, lack of self-efficacy, medication aids and technology to enhance medication adherence. Caregivers’ lack of knowledge reduces their self-efficacy in managing medications and increases their burden of care. The majority of caregivers used technology and welcomed its use to assist them with their role.

Conclusion: Caregivers require knowledge and support such as a multifaceted technology based intervention to assist with medication adherence.     

Early cutis marmorata telangiectatica congenita masquerading as ulcerated retiform purpura: a diagnostic trap

Cutis marmorata telangiectatica congenita (CMTC) is a rare congenital cutaneous vascular anomaly with a reticular marbled erythematous pattern, which can result in isolated benign skin lesions or less commonly be associated with systemic anomalies. Occasionally, the characteristic pattern of CMTC lesions is masked on initial presentation, creating a diagnostic conundrum that can result in unnecessary workups to rule out vasculopathy. We present the case of a female newborn with a red-blue ulcerated skin lesion on the right leg and foot, which initially appeared as retiform purpura but evolved to exhibit the mottled pattern of CMTC by 5 days of age. Clinicians must be made aware of this potential diagnostic trap in early CMTC to avoid invasive skin biopsies and unnecessary laboratory testing in neonates.     

Increased Firearm Injury During the COVID-19 Pandemic: A Hidden Urban Burden

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The Impact of Alexithymia on Desire for Alcohol during a Social Stress Test

Background: Alexithymia is a personality construct comprising difficulty in identifying and describing emotions and externally oriented thinking. Its role in heavy and problematic alcohol consumption is well documented, together with its relationship with social stress. However, little research has examined whether social stress has any effect on desire for alcohol among alexithymic individuals. Objectives: In this experimental study, we explored the relationship between alexithymia and desire for alcohol in response to an experimental social stressor. Methods: One hundred and thirty eight social drinkers completed the Toronto Alexithymia Scale, self-report measures of alcohol consumption and a stress-inducing task. Desire for alcohol was measured at three time points: baseline, stressor and recovery. Results: Correlation analysis demonstrated that alexithymia was associated with significantly higher rates of alcohol consumption and higher levels of desire for alcohol. Mixed measures ANOVA demonstrated a significant main effect of alexithymia and a significant group by time effect of alexithymia on desire for alcohol. Conclusions/Importance: The findings demonstrate increased desire for alcohol before, during and after a social stressor among alexithymic participants. These findings offer an insight into the relationship between alexithymia, social stress and alcohol consumption.