The Effectiveness Study of a Memory Intervention to Improve Medication Adherence in Patients with Mild Cognitive Impairments

The role of prospective memory (PM) in medication adherence is highlighted by recent related research. Growing literature suggests the increased risk of non-adherence links to attention, executive function and PM. Researchers and health professionals may therefore benefit from identifying novel cognitive predictors of adherence such as PM that can inform treatment recommendations However, a lack of attention to potentially important confounders such as decision making and self unawareness of patients with cognitive impairment (PWCIs) has raised questions of response bias and subject to Type I error. Therefore, the purposes of this study are threefold: (1) to develop a everyday decision making instrument for PWCIs to appropriately address the issues of confounding effects of PM, (2) to test an exploratory conceptual model which explicitly link self awareness, decision making and PM to predict medication adherence in PWCIs, and (3) to develop a multifaceted PM intervention to improve medication adherence and quality of life in PWCIs. It will be a 3-year project. The purpose of this first year is to translate an everyday decision making instrument, the Assessment of Capacity for Everyday Decision-Making (ACED) into Chinese and to conduct a small pilot study to examine its language equivalence and reliability. Since the instruction of the ACED requires to interview family caregivers (FCGs) of PWCIs, we will recruit FCGs in this project as well. Sample size for the first year will be 6 dyads. The second year will be a cross-sectional study to formally test the validity of the Chinese ACED. The indicators of validity include item difficulty, exploratory principal component factor analysis, discriminant validity, instrument homogeneity, and hypothesis testing. Sample size for the second year project will be 98 dyads. In the third year, we will conduct a randomized clinical trail to examine the effectiveness of a multifaceted memory intervention to improve medication adherence and quality of life in PWCIs. The intervention group (the dyad of PWCIs and their FCGs) will receive an educational and evidence-based memory strategy training specific for dementia management and medication adherence, while the control group will receive only educational intervention on dementia treatment and medication adherence. The evidence based memory strategies will focus on the components of PM. The sample size for each group will be 42 dyads (total n = 84 dyads). The three-year program will help to identify those who may benefit from cognitive rehabilitation and assist those who may be incompetent in medication management. Also our program will extend the current knowledge of the PM role in medication adherence behavior and its relationships with self awareness as well as everyday decision making.

Project ID:PC10301-0546
External Project ID:NSC102-2314-B182-050-MY2