‘Has she seen me?’: a multiple methods study of the pharmaceutical care needs of older people with sensory impairment in Scotland

Abstract

ObjectivesTo explore the pharmaceutical care needs of, and service provision to, older people with sensory impairment (visual, hearing and dual impairment) on prescribed polypharmacy (≥4 medicines) in Scotland.DesignInterviews were conducted with older people with sensory impairment and community pharmacy personnel, which informed the content of a subsequent national cross-sectional survey of community pharmacists.SettingScotland, 2015–2016.ParticipantsOlder people with sensory impairment and community pharmacy personnel.ResultsInterviews were completed with 23 older people with sensory impairment (dual impairment n=13, visual or hearing impairment n=5 of each) and 30 community pharmacy personnel from eight of 14 Scottish Health Boards. A total of 171 survey responses were received.Older people reported that they did not always disclose their sensory impairment to pharmacy personnel. They also reported that medicines were difficult to identify particularly when their name, shape or colour changed. Pharmacy personnel relied on visible cues such as white canes or guide dogs to identify visual impairment and suggested that hearing loss was less visible and more difficult to identify. Many assistive aids in support of medicine management, such as dosette boxes, seemed inadequate for complex medication regimens. Few community pharmacy personnel reported receiving training in the care of people with sensory impairment.ConclusionsThis is the first comprehensive, multistakeholder, in-depth exploration of the pharmaceutical care needs of older people with sensory impairment. Strategies are needed to enable people with sensory impairment to disclose their impairment to pharmacy personnel (and other healthcare providers). Community pharmacy personnel require training to deliver person-centred pharmaceutical care for older people with sensory impairment particularly regarding communication with individuals in this vulnerable population.

An exploration of the experiences of professionals supporting patients approaching the end of life in medicines management at home. A qualitative study.

“…In line with the international literature, the HCPs participating in this study recognised the burdens of polypharmacy at end of life 15,17,[20][21][22] , but did not always seem to acknowledge how the burdens of medication management added to the 'work' patients and FCG's were undertaking when someone is seriously ill in the home environment 23 . FCGs are also more likely to be older, and have reduced abilities and comorbidities of their own 24 . Until recently much of the literature on medication management focused on 'adherence' and 'compliance' and the implication for health outcomes 5,[25][26][27][28] .…”

A systematic review of pharmacists’ interventions to support medicines optimisation in patients with visual impairment

“…Many difficulties may prevent the development and implementation of interventions to optimise medicines use for patients with visual impairment. These include the lack of time, staff, sufficient training and availability of assistive technology to produce accessible information, as well as the lack of the awareness of pharmacy staff of the needs of people with visual impairment [16,50,51]. One reason for pharmacists' lack of awareness may be their failure to identify such patients in everyday practice.…”

“…A recent scoping review of the pharmaceutical care needs of people with sensory loss (hearing and/or vision loss) highlighted the paucity of studies examining the pharmaceutical care needs of this population [9]. Challenges to medicines use experienced by those who are visually impaired include problems with distinguishing between medicines, doses and expiration dates as well as adherence issues [9][10][11][12][13][14][15][16]. Patients with visual impairment often need to rely on family members or carers to help with medicines [9].…”

Creative communication in networking services as the social skill of geriatric pharmacist

“…The communication is aimed at related parties as a series of interventions that have been carried out for elderly patients. Four other research articles included in this review come from qualitative studies (Alhusein et al, 2019(Alhusein et al, , 2018Schmidt-Mende et al, 2018;Wood et al, 2015). Qualitative study designs often use interviews and focus group discussions that can reveal new ideas as creativity from pharmacists that are applied to establish communication in networking services.…”

“…The elderly need special attention, so the geriatric pharmacist requires individualization therapy skills (Chen et al, 2016;Markle-Reid et al, 2010) . Pharmacists can conduct home visits and counseling at elderly homes to simplify complex dosage regimens (Alhusein et al, 2018;Wood et al, 2015). Pharmacists can also identify Drug Related Problems (DRPs) through Medication Review (MR) activities and communicate them with doctors (Flanagan and Barns, 2018).…”