Caregiver‐Based Interventions to Optimize Medication Safety in Vulnerable Elderly Adults: A Systematic Evidence‐Based Review

Wagle, Kamal C.; Skopelja, Elaine N.; Campbell, Noll L.

doi:10.1111/jgs.15556

Cited by 23 publications

(19 citation statements)

References 25 publications

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“…A systematic review of transitional care education interventions for carers of older adults who have experienced stroke found that education was effective in reducing carer burden and anxiety 13 . In another systematic review, home‐ and outpatient‐based medication reviews in the follow‐up period after hospitalization improved carers' medication knowledge and self‐efficacy 14 . Other studies have identified that carers need support with problem solving and decision‐making during the follow‐up discharge period, 15–19 support to access and navigate community‐based programmes 20–22 and support to clarify expectations of services 23 .…”

Section: Introductionmentioning

confidence: 99%

Informal carers' support needs, facilitators and barriers in the transitional care of older adults: A qualitative study

Allen

Lobchuk

Livingston

et al. 2022

Health Expectations

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Introduction Inclusion of informal carers in transitional care is challenging because of fast throughput and service fragmentation. This study aimed to understand informal carers' needs during the care transitions of older adults from inpatient care to the community. Methods A qualitative exploratory design was used with mixed‐methods data collection. Seventeen semi‐structured telephone interviews were conducted with family carers; one focus group was conducted by videoconference with two family carers and three community‐based advocacy and aged care providers; and eight semi‐structured telephone interviews were undertaken with healthcare practitioners from rehabilitation services. Data were thematically analysed. Findings All carers described the main social challenge that they needed to address in transitional care as ‘Needing to sustain family’. Carers reported their social needs across five solutions: ‘Partnering with carers’, ‘Advocating for discharge’, ‘Accessing streamlined multidisciplinary care’, ‘Knowing how to care’ and ‘Accessing follow‐up care in the community’. Focus group participants endorsed the findings from the carer interviews and added the theme ‘Putting responsibility back onto carers’. All healthcare practitioners described the main social challenge that they needed to address as ‘Needing to engage carers’. They reported their social solutions in three themes: ‘Communicating with carers’, ‘Planning with carers’ and ‘Educating carers’. Discussion Findings highlight the importance of reconstructing the meaning of transitional care and relevant outcomes to be inclusive of carers' experiences and their focus on sustaining family. Transitional care that includes carers should commence at the time of hospital admission of the older adult. Conclusions Future sustainable and high‐quality health services for older adults will require transitional care that includes carers and older adults and efficient use of inpatient and community care resources. Healthcare professionals will require education and skills in the provision of transitional care that includes carers. To meet carers' support needs, models of transitional care inclusive of carers and older adults should be developed, implemented and evaluated. Public Contribution This study was conducted with the guidance of a Carer Advisory Group comprising informal carers with experience of care transitions of older adults they support and community‐based organizations providing care and advocacy support to informal carers.

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Section: Introductionmentioning

confidence: 99%

Informal carers' support needs, facilitators and barriers in the transitional care of older adults: A qualitative study

Allen

Lobchuk

Livingston

et al. 2022

Health Expectations

View full text Add to dashboard Cite

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“…For example, their work has a positive impact on clinical outcomes and healthcare-resource utilization, reducing the number of hospitals visits [10] and mortality [11], and improving QoL or other patient-reported outcomes [12]. Their value has also been recognised in the care of nonhospitalised patients [13], in long-term care settings [14], and even in the delivery of home visits [15,16].…”

Section: Introductionmentioning

confidence: 99%

Effects of hospital pharmacist interventions on health outcomes in older polymedicated inpatients: a scoping review

et al. 2021

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Aim Do patients receiving polypharmacy benefit from interventions by hospital pharmacists, individually or as part of a multidisciplinary team? Findings Some beneficial effects were found of pharmacist interventions in 15 of 26 studies, specifically on hospital readmission, visits to the emergency department and healthcare costs. Message Evidence in favour of hospital pharmacist interventions in polymedicated older patients is scarce. Well-designed studies, with clearly defined interventions, outcomes and follow-up times should be conducted in the future to define the role of pharmacists in the geriatric team.

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“…Caregivers requested that they were advised of discharge processes at admission so that they had time to process the information and think about what questions to ask. Early discharge planning (initiated during the acute phase of an illness or injury) delivered to caregivers of older adults has been shown to be effective in improving outcomes in older adults 36,37 . Given that caregivers of people with dementia experience a higher degree of burden than the caregiver of a person without dementia, 38 early pre‐discharge intervention delivered to caregivers of people with dementia may improve medication management activities post discharge.…”

Section: Discussionmentioning

confidence: 99%

Caregivers' experiences of medication management advice for people living with dementia at discharge

Sawan

Jeon

Bond

et al. 2021

Evaluation Clinical Practice

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Rationale, Aims, and Objectives Caregivers of people living with dementia play an essential role in managing medications across transitions of care. Adequate caregiver medication management guidance at hospital discharge is important to ensure optimal outcomes from medication use. This qualitative study explores the experiences and perspectives of caregivers about the medication management guidance provided at hospital discharge. Methods A qualitative approach using semi‐structured, telephone interviews was conducted with 31 caregivers of people with dementia across Australia. Purposive sampling was used to ensure maximum variation of diverse experiences and perspectives. Results Caregivers' experiences of medication guidance for people with dementia at discharge were described in three themes including: (a) inadequate information about medication management at discharge; (b) limited caregiver engagement in medication management decisions; and (c) difficulties ensuring medication supply post discharge. Most participants indicated they would like to be included in discussions at discharge. However, participation was influenced by caregivers being overwhelmed by discharge processes; proactively seeking information on medication‐related harm; and belief in advocacy as part of their caregiver role. Caregivers reported they would like to receive a tailored medication list for people with dementia which included information on medications that may impact on the patient's cognition, and for hospital staff to communicate with both the community pharmacist and primary care physician, to improve co‐ordination post transition. Discussion In our study of caregivers of people with dementia, we identified key recommendations to facilitate regular participation of people living with dementia and their caregiver around medication guidance at discharge.

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Caregiver‐Based Interventions to Optimize Medication Safety in Vulnerable Elderly Adults: A Systematic Evidence‐Based Review

Cited by 23 publications

References 25 publications

Informal carers' support needs, facilitators and barriers in the transitional care of older adults: A qualitative study

Informal carers' support needs, facilitators and barriers in the transitional care of older adults: A qualitative study

Effects of hospital pharmacist interventions on health outcomes in older polymedicated inpatients: a scoping review

Caregivers' experiences of medication management advice for people living with dementia at discharge

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