HomeCare Medication Management for People With Dementia

This is a two-arm randomized controlled trial evaluating the HomeCare Pharmacy Distribution System for medication management among adults living with dementia, Alzheimer's disease, or Alzheimer's disease-related dementias. The study will enroll 120 participants with dementia and their caregivers. Participants will be randomized to either the HomeCare intervention group or a standard-care control group. Participants assigned to the intervention group will use the HomeCare system for medication management. The system is designed to automate medication dispensing, monitor medication adherence, document medication-use patterns, and provide real-time alerts to caregivers. Participants assigned to the control group will continue using traditional medication-management methods, including pill bottles or blister packs. The primary objective is to evaluate medication adherence over 12 months. Medication adherence will be assessed using the Medication Adherence Rating Scale and Proportion of Days Covered, together with medication-use information collected through the HomeCare system for participants in the intervention group. Additional outcomes will include hospitalizations and emergency room visits, cognitive function, caregiver burden, quality of life, satisfaction, and behavioral changes related to medication management. Cognitive function will be assessed using the Everyday Cognition assessment at baseline, 6 months, and 12 months. Caregiver burden and quality-of-life measures will also be collected during the study. Caregivers in both study groups will receive study-related training and will complete surveys and other assessments related to caregiver burden, quality of life, medication-management activities, and their experience supporting the participant. Participants will be age 65 or older and will have dementia, Alzheimer's disease, or a related dementia. The study will be conducted in collaboration with the University of California, Davis. Participants will be followed for 12 months. Study procedures include regular participant and caregiver follow-up, monitoring for device-related issues and adverse events, and collection of study outcome data. Safety procedures include participant and caregiver training, regular study-team contact, secure handling of study data, and access to backup medication supplies if technical problems with the HomeCare device occur. Participants may withdraw from the study at any time.