Komplexe Medikamentenregime bei multimorbiden älteren Menschen nach Spitalaufenthalt – eine qualitative Studie

Stauffer, Yvonne; Spichiger, Elisabeth; Mischke, Claudia

doi:10.1024/1012-5302/a000400

Cited by 6 publications

(10 citation statements)

References 15 publications

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“…male gender, cognitive or sensory impairment, are associated with greater medicine management needs and challenges among the older population. 6 , 7 , 8 , 9 , 10 , 11 , 12 Community dwelling older adults are at higher risk of adverse drug reactions (ADRs) and hospital admission. 13 Theses risks are exacerbated by inappropriate prescribing and monitoring of medications and polypharmacy.…”

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confidence: 99%

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“We're really not ready for this”: A qualitative exploration of community pharmacy personnel's perspectives on the pharmaceutical care of older people with sensory impairment

Alhusein

Killick

Macaden

et al. 2019

Disability and Health Journal

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Background In most developed countries there is an increasing ageing population living in the community with long-term conditions and sensory impairment (sight; hearing; dual impairment). Community pharmacy personnel are key providers of pharmaceutical care to this patient population. Objective This study explored community pharmacy personnel's experiences with providing pharmaceutical care for older people with sensory impairment. Methods Semi-structured telephone interviews were conducted with community pharmacy personnel across Scotland between 2015 and 2016. Results Thirty interviews were completed with community pharmacists (n = 17) and other pharmacy personnel (n = 13). Two overarching themes emerged: safety and communication. Interviewees reported patients' reluctance to disclose their impairment “patients are very good at hiding it” and had considerable safety concerns “ it's a fear that they're going to take too much … accidentally taking the same medicine twice ”. Difficulties in communication were cited “ no matter what you do or how you label things, leaflets and telling people, things can go wrong ”. Additionally, interviewees identified training needs to increase their disability awareness and to identify strategies to provide safe and reliable pharmaceutical care to this vulnerable group “We don't specifically have anything in place to deal with anyone with impairments of that kind”. Conclusions This is the first in-depth exploration of providing pharmaceutical care to older people with sensory impairment from the perspective of community pharmacy personnel. Strategies are needed to encourage older people to disclose their sensory impairment. Education and training are also needed to optimise the provision of pharmaceutical care to this vulnerable population.

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confidence: 99%

“…Demographic and functional characteristics e.g. male gender, cognitive or sensory impairment, are associated with greater medicine management needs and challenges among the older population 6, 7, 8, 9, 10, 11, 12. Community dwelling older adults are at higher risk of adverse drug reactions (ADRs) and hospital admission 13 .…”

mentioning

confidence: 99%

“We're really not ready for this”: A qualitative exploration of community pharmacy personnel's perspectives on the pharmaceutical care of older people with sensory impairment

Alhusein

Killick

Macaden

et al. 2019

Disability and Health Journal

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“…32 – 35 However, the GP appears to be the key person influencing the proper use of new prescriptions initiated in the hospital. 28 Despite the significance of these studies, they did not extend to the medication practices of older adults returning home after hospitalization, or their adherence and adjustments over time. They also failed to identify the involvement of professional or informal caregivers in this sensitive context.…”

Section: Introductionmentioning

confidence: 98%

“… 25 , 26 These few works indicated that older adults felt that there was a lack of clear, understandable explanations about changes to medication at hospital discharge, and that there was little opportunity to question health care professionals about their medication during their hospital stays. 27 , 28 Inadequate explanations about medications not only result in omissions and incorrect dosages, but also anxiety and confusion in older adults. 29 Although patients have different information needs about their drugs in this transitional phase, most would like to receive basic information about their treatments.…”

Section: Introductionmentioning

confidence: 99%

Medication practices and experiences of older adults discharged home from hospital: a feasibility study protocol

Roux

Pereira

Santiago-Delefosse

et al. 2018

PPA

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BackgroundSwitzerland’s aging population raises pressing questions about maintaining older adults in their home environments and the problems associated with managing complex treatments requiring medication in such contexts. Few studies have examined older adults’ experiences of changes in their medication on discharge home following hospitalization for illness or an accident. Similarly, few studies have evaluated the involvement of informal and professional caregivers in the medication practices used with older adults living at home. However, medication practices are complex and understanding them requires an interest in their underlying logic and the interactions that constitute them. This study will explore the feasibility of recruiting older adults and then collecting and analyzing data on their medication practices and their experiences of discharge home after hospitalization for an illness or following an accident. Furthermore, it will describe the involvement of informal caregivers and homecare professionals in these processes.Design and methodsThe study will use a qualitative methodology. The first phase will be developed in the general medicine and surgery wards of Sion hospital and in the town’s community healthcare center. This phase will aim to build a close collaboration between the research team and the health care professionals of Valais hospitals and the community healthcare center. It will enable data collection from professional caregivers to identify the tools, and potentially the interventions, which are used to prepare older adults for hospital discharge and return home, particularly with regard to the medication prescribed to them. In the second phase, semi-structured interviews will be conducted with eight patients aged 75 years old or more who have returned home after hospitalization. Interviews will also be conducted with their informal and professional caregivers.ConclusionThis feasibility study will enable the identification of tools that leverage improved adhesion to a medical treatment that has been adjusted and stabilized following discharge home from hospital. It will incorporate the points of view of older adults and the different stakeholders involved in the management of their medication and the development of tangible solutions to encourage treatment adhesion on discharge home. This study’s findings will enable us to design a much larger future study.

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“…If the design and accompanying informational materials of drug products do not match users' needs and capacities, the proper use—hence safety and effectiveness—of even the most efficacious product can be compromised. In other words, drug products that are difficult to take/administer may not be used properly, resulting in unnecessary medication errors, or may not be used at all, jeopardizing therapeutic success …”

Section: Introductionmentioning

confidence: 99%

Heuristics for designing user‐centric drug products: Lessons learned from Human Factors and Ergonomics

Feufel

Rauwolf

Meier

et al. 2020

Brit J Clinical Pharma

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Even the most effective drug product may be used improperly and thus ultimately prove ineffective if it does not meet the perceptual, motor and cognitive capacities of its target users. Currently, no comprehensive guideline for systematically designing user‐centric drug products that would help prevent such limitations exists. We have compiled a list of approximate but nonetheless useful strategies—heuristics—for implementing a user‐centric design of drug products and drug product portfolios. First, we present a general heuristic for user‐centric design based on the framework of Human Factors and Ergonomics (HF/E). Then we demonstrate how to implement this general heuristic for older drug users (i.e., patients and caregivers aged 65 years and older) and with respect to three specific challenges (use‐cases) of medication management: (A) knowing what drug product to take/administer, (B) knowing how and when to take/administer it, and (C) actually taking/administering it. The presented heuristics can be applied prospectively to include existing knowledge about user‐centric design at every step during drug discovery, pharmaceutical drug development, and pre‐clinical and clinical trials. After a product has been released to the market, the heuristics may guide a retrospective analysis of medication errors and barriers to product usage as a basis for iteratively optimizing both the drug product and its portfolio over their life cycle.

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Komplexe Medikamentenregime bei multimorbiden älteren Menschen nach Spitalaufenthalt – eine qualitative Studie

Cited by 6 publications

References 15 publications

“We're really not ready for this”: A qualitative exploration of community pharmacy personnel's perspectives on the pharmaceutical care of older people with sensory impairment

“We're really not ready for this”: A qualitative exploration of community pharmacy personnel's perspectives on the pharmaceutical care of older people with sensory impairment

Medication practices and experiences of older adults discharged home from hospital: a feasibility study protocol

Heuristics for designing user‐centric drug products: Lessons learned from Human Factors and Ergonomics

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