Engaging caregivers to use an evidence‑based intervention for medicaid benefciaries with Alzheimer’s disease: a pilot study

Background This pilot study aimed to adapt an intervention, engaging informal caregivers to help clinicians with providing care to improve (or maintain) physical function of individuals with Alzheimer’s Disease or other dementias. To the best of our knowledge, for the frst time, we report on use of the intervention in those with Alzheimer’s Disease or other dementias. Methods This was a 5-month mixed methods cohort study in a convenience sample of clinicians, caregivers, and benefciaries at 3-Medicaid Home and Community-based Service sites in Michigan. Two content experts and 5 caregivers modifed the intervention. We trained 116 clinicians to engage caregivers and 50 caregivers to help clinicians provide the modifed intervention to 52 benefciaries with Alzheimer’s Disease or other dementias. Thematic analyses, descriptive statistics, counts, proportion comparisons, t-tests, and McNemar’s tests were used to examine socio-demographics, clinician knowledge uptake and satisfaction with training and use of the intervention; caregiver self-efcacy, feasibility, acceptability, usability, and satisfaction with intervention and benefciary outcomes (pre-/post). Results Feasibility (enrolled/recruited=78.5–86.7%), acceptability (7.55–8.35 [SD 1.50–2.06]), and usability (7.85–8.81 [SD 1.50–2.6]) of the modifed intervention (1=low;10=high) were high. Pre-/post-intervention clinician knowledge (12.33–12.28, SD 1.80–2.84; -0.52, SD 1.95) was high. Caregiver self-efcacy increased (0.81 [SD 0.62] p\u3c0.01). Benefciary outcomes did not improve nor decline (\u3e0.05). Conclusions Engaging informal caregivers to assist clinicians with providing an intervention adapted to the needs of those with Alzheimer’s Disease or other dementias was feasible, acceptable, and usable. Further testing in a broader sample of those with dementia in various settings is needed

Assessment and Measurement of Adherence to Oral Antineoplastic Agents

OBJECTIVES: The increase in oral anticancer medications with complex regimens creates a need to assure patients are taking therapeutic dosages as prescribed. This article reviews the assessment and measurement of adherence to oral antineoplastic agents. DATA SOURCE: Research and journal articles from CINAHL and Pub Med. CONCLUSION: Assessing and measuring adherence to oral antineoplastic should include three dimensions: the percentage of medications taken, the duration, and the timing of taking the medication. IMPLICATIONS FOR PRACTICE: Clinicians need to conduct ongoing assessment and measurement of adherence to oral antineoplastic agents. This includes eliciting patient report of adherence, pill counts, drug diaries, and pharmacy or medical record audits