The roles of informal carers in the management of medication for older care-recipients

Objective - To document the roles of informal carers in the management of medication for older care-recipients and to relate this to carers' coping and health. Method - Carers were identified and recruited in randomly selected community pharmacies in England. All pharmacy clients aged over 18 years who were collecting a prescription on behalf of someone aged 60 years or more, and were unpaid as a carer, were invited to participate in a home interview. Data were collected in structured interviews. Recruitment of carers in the pharmacies and home interviews were undertaken by teams of local interviewers. Setting - Four randomly selected health authority areas in England stratified according to the proportion of the population aged over 65 years, proportion of the population from ethnic minority groups and socio-economic status. Key findings - Carers undertook between one and 10 medication-related activities (median=6), ranging from contact with surgeries and pharmacies to clinical decision-making in the home. Different levels of involvement in, and approaches to, medication-related activities were described by carers in the context of their relationship with the care-recipient. The total number of medication-related activities was positively correlated with carer strain and negatively correlated with social functioning and mental health. Conclusion - Support for informal carers is a priority for the British Government which recognises their important contribution to health care. In documenting the medication-related assistance provided by carers this paper identifies key considerations for the pharmacy profession in developing carer-centred pharmacy services.