Exploring the past, present and future of care home medicine management systems: pharmacists' perceptions of multicompartment compliance aids

Gilmartin, Julia Fiona-Maree; Jani, Yogini; Smith, Felicity

doi:10.1111/jphs.12105

Cited by 3 publications

(1 citation statement)

References 37 publications

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“…10 Pharmacists predict continued use of MCAs in the future due to their perceived benefits of improved safety and efficiency. 10 This is despite the Royal Pharmaceutical Societies of England and Scotland cautioning against the routine use of MCAs, calling for a need to review the value of their continued use, 11 taking into account the evidence-base for their effectiveness as one medication adherence intervention amongst many. 12 Published research has also explored pharmacist perceptions of stability issues associated with medications packed into MCAs 13 and pharmacy dispensing incidents associated with their preparation.…”

Section: Introductionmentioning

confidence: 99%

A comparison of medication administration errors from original medication packaging and multi-compartment compliance aids in care homes: A prospective observational study

Gilmartin‐Thomas

Smith

Wolfe

et al. 2017

International Journal of Nursing Studies

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The significant difference in, and high overall, medication administration error rate between original medication packaging and multi-compartment compliance aids supports the use of the latter in care homes, as well as local investigation of tablet and capsule impact on medication administration errors and staff training to prevent errors occurring. As a significant difference in error rate was not observed between use of a single or combination medication administration system, common practice of using both multi-compartment compliance aids (for most medications) and original packaging (for medications with stability issues) is supported.

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Section: Introductionmentioning

confidence: 99%

A comparison of medication administration errors from original medication packaging and multi-compartment compliance aids in care homes: A prospective observational study

Gilmartin‐Thomas

Smith

Wolfe

et al. 2017

International Journal of Nursing Studies

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The importance of pharmacist and researcher collaboration to inform clinical audit and optimise medicine services in aged care facilities

Gilmartin

Fowkes

2016

Research in Social and Administrative Pharmacy

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Medication administration in aged care facilities: A mixed‐methods systematic review

Garratt,

Dowling,

Manias

2024

Journal of Advanced Nursing

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Aim(s)To synthesize aged care provider, resident and residents' family members' perspectives and experiences of medication administration in aged care facilities; to determine the incidence of medication administration errors, and the impact of medication administration on quality of care and resident‐centredness in aged care facilities.DesignA mixed‐methods systematic review. PROSPERO ID: CRD42023426990.Data SourcesThe AMED, CINAHL, MEDLINE, EMBASE, EMCARE, PsycINFO, Scopus and Web of Science core collection databases were searched in June 2023.Review MethodsIncluded studies were independently screened, selected and appraised by two researchers. The Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) checklist was followed, with the Mixed Methods Appraisal Tool was used for critical appraisal. Convergent synthesis of data, thematic synthesis and meta‐analysis were performed.ResultsOne hundred and twenty‐eight studies were included (33 qualitative, 85 quantitative and 10 mixed‐methods). Five themes were formulated, including 1) Staffing concerns, 2) The uncertain role of residents, 3) Medication‐related decision‐making, 4) Use of electronic medication administration records and 5) Medication administration errors. Educational interventions for aged care workers significantly reduced medication administration errors, examined across five studies (OR = 0.37, 95%CI 0.28–0.50, p < .001).ConclusionsMedication administration in aged care facilities is challenging and complex on clinical and interpersonal levels. Clinical processes, medication errors and safety remain focal points for practice. However, more active consideration of residents' autonomy and input by aged care workers and providers is needed to address medication administration's interpersonal and psychosocial aspects. New directions for future research should examine the decision‐making behind dose form modification, aged care workers' definitions of medication omission and practical methods to support residents' and their family members' engagement during medication administration.Implications for the profession and/or patient careIt is important that medication administration in aged care facilities be more clearly acknowledged as both a clinical and interpersonal task. More attention is warranted regarding aged care workers clinical decision‐making, particularly concerning dose form modification, covert administration and medication omissions. Resident‐centred care approaches that support resident and family engagement around medication administration may improve adherence, satisfaction and quality of care.ImpactWhat Problem Did the Study Address? Medication administration in aged care facilities is a complex clinical and interpersonal activity. Still, to date, no attempts have been made to synthesize qualitative and quantitative evidence around this practice. There is a need to establish what evidence exists around the perspectives and experiences of aged care workers, residents and resident's family members to understand the challenges, interpersonal opportunities and risks during medication administration.What Were the Main Findings? There is a lack of empirical evidence around resident‐centred care approaches to medication administration, and how residents and their families could be enabled to have more input. Dose form modification occurred overtly and covertly as part of medication administration, not just as a method for older adults with swallowing difficulties, but to enforce adherence with prescribed medications. Medication administration errors typically included medication omission as a category of error, despite some omissions stemming from a clear rationale for medication omission and resident input.Where and on Whom Will the Research Have an Impact?The findings of this systematic review contribute to aged care policy and practice regarding medication administration and engagement with older adults. This review presents findings that provide a starting point for aged care workers in regards to professional development and reflection on practice, particularly around clinical decision‐making on dose form modification, medication administration errors and the tension on enabling resident input into medication administration. For researchers, this review highlights the need to develop resident‐centred care approaches and interventions, and to assess whether these can positively impact medication administration, resident engagement, adherence with prescribed medications and quality of care.Reporting MethodThis systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (Page et al., 2021).Patient or Public ContributionNo patient or public contribution to this systematic review.

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Exploring the past, present and future of care home medicine management systems: pharmacists' perceptions of multicompartment compliance aids

Cited by 3 publications

References 37 publications

A comparison of medication administration errors from original medication packaging and multi-compartment compliance aids in care homes: A prospective observational study

A comparison of medication administration errors from original medication packaging and multi-compartment compliance aids in care homes: A prospective observational study

The importance of pharmacist and researcher collaboration to inform clinical audit and optimise medicine services in aged care facilities

Medication administration in aged care facilities: A mixed‐methods systematic review

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