Ghanem, Karyman Ahmed Fawzy2026-01-162026-01-162026-01-162026-01-08https://hdl.handle.net/10012/22833Background: Older adults with multiple chronic conditions often manage complex medication regimens. Age-related physical and cognitive impairments further complicate this process and increase the risk of medication errors and non-adherence. Informal caregivers, including family, friends, and neighbors, play a crucial role in supporting this process. However, many caregivers feel unprepared for the complex and time-consuming tasks involved in medication management. As a result, they may experience significant caregiver burden, which affects their emotional, social, financial, and physical well-being and can contribute to anxiety, poor self-care, sleep disruption, social isolation, or even suicidal thoughts. Objectives: 1. To evaluate the impact of an automated medication dispenser (AMD) on compassion fatigue, satisfaction, and medication administration hassles. 2. To develop a medication management toolkit to support family caregivers with medication management at home. Methods: Study one is a pilot mixed-methods study that recruited 7 pairs of family caregivers and their older care recipients. Caregivers completed the Family Caregiver Medication Administration Hassles Scale (FCMAHS) and the Professional Quality of Life Scale (ProQoL) at baseline, 2 weeks, and 3 months after implementing AMD in care recipients’ homes. Caregivers were interviewed before and after using AMD. The interviews were recorded, transcribed, and thematically analyzed. Study two is a qualitative study in which 16 family caregivers participated in focus group discussions to identify medication management challenges and solutions that will inform the development of the toolkit. Results: In study one, Friedman tests showed no significant change in FCMAHS subscale scores over time after Bonferroni correction (α =0.0125; all p > 0.0125). The total score (primary outcome) was assessed without correction (α = 0.05) and was not significant. Wilcoxon Signed-Rank Tests showed a similar pattern, except for a significant reduction in total score from baseline to 3 months (p=0.02). Both tests showed no significant change in scores for the subscales of ProQoL after Bonferroni correction (α= 0.0167); all p > 0.0167). Three themes emerged from the pre-intervention interviews: becoming a caregiver, approaches to support medication management, and caregiver experience and well-being. Four themes emerged from the post-intervention interview analysis: usability and functionality, experience with remotely delivered pharmacy services, caregiver experience and well-being, and impact on the caregiver–recipient relationship. Six themes emerged from study two: caregiver–recipient relationship and caregiving context; challenges with medication management; medication management strategies; non-medication management tasks; caregivers’ preferences for toolkit format and content; and additional support with medication management. Conclusion: Study one shows that the long-term use of AMD has the potential to be beneficial for caregiving burden related to medication management but is influenced by the caregiver’s adjustment period. Future research should verify these pilot findings. Study two shows that family caregivers manage medications across several domains in which they face challenges, including scheduling doses, supporting adherence, tracking medication supplies, and communicating with healthcare professionals. To assist with these tasks, caregivers often rely on simple and traditional tools and strategies.eninformal caregiverscaregiver burdenmedication managementtecnhologytoolkitcompassion fatiguecompassion satisfactionMaster Thesis