Background There is a strong imperative to support people with dementia to live independently in their homes for as long as possible. A starting point is to understand how they manage medications on a daily basis. Aim To understand how people with dementia and their informal carers manage medications within the home setting to inform the identification of opportunities to improve medication management. Methods A qualitative study using the Functional Resonance Analysis Method (FRAM). Interview data with people with dementia and informal carers were analysed to (i) Identify and describe key functions, (ii) identify and describe variability in performing key functions, and its potential consequences and (iii) map performance variability to Resilient Healthcare capacities. Results and discussion A FRAM model was developed and consisted of 14 interdependent key functions. The interdependent nature of functions, and the different nature and sources of variability in how each key function was performed highlighted the level of complexity of the medication management system within the home setting. The medication system was managed almost entirely by the person with dementia and/or their informal carers. This shows the lack of system-level controls to support the safe functioning of the medication management system in the home setting. Conclusion Future work will develop a comprehensive FRAM model that includes the perspectives of health and social care professionals and those from the third sectors to underpin the development of a range of system recommendations to strengthen resilience in the medication management system within the home setting.

中文翻译：

---

应对家庭环境中药物管理系统的复杂性——对痴呆症患者及其护理人员的经历进行功能共振分析方法 (FRAM) 分析


背景 迫切需要支持痴呆症患者尽可能长时间地在家中独立生活。首先是了解他们如何每天管理药物。目标 了解痴呆症患者及其非正式护理人员如何在家庭环境中管理药物，以便确定改善药物管理的机会。方法 使用功能共振分析法 (FRAM) 进行定性研究。对痴呆症患者和非正式护理人员的访谈数据进行了分析，以 (i) 识别和描述关键职能，(ii) 识别和描述执行关键职能的可变性及其潜在后果，以及 (iii) 将绩效可变性映射到弹性医疗保健能力。结果和讨论 开发了一个 FRAM 模型，该模型由 14 个相互依赖的关键函数组成。功能的相互依赖性质以及每个关键功能执行方式的不同性质和可变性来源突出了家庭环境中药物管理系统的复杂程度。药物系统几乎完全由痴呆症患者和/或其非正式护理人员管理。这表明缺乏系统级控制来支持家庭环境中药物管理系统的安全运行。结论 未来的工作将开发一个全面的 FRAM 模型，其中包括健康和社会护理专业人员以及第三部门的观点，以支持一系列系统建议的制定，以增强家庭环境中药物管理系统的弹性。