Ahmad Nizaruddin Mariani, Omar Marhanis-Salihah, Mhd-Ali Adliah, Makmor-Bakry Mohd
Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Patient Prefer Adherence. 2017 Nov 1;11:1869-1877. doi: 10.2147/PPA.S144513. eCollection 2017.
Globally, the population of older people is on the rise. As families are burdened with the high cost of care for aging members, demand is increasing for medical care and nursing homes. Thus, medication management is crucial to ensure that residents in a care center benefit and assist the management of the care center in reducing the burden of health care. This study is aimed to qualitatively explore issues related to medication management in residential aged care facilities (RACFs).
A total of 11 stakeholders comprising health care providers, administrators, caretakers and residents were recruited from a list of registered government, nongovernmental organization and private RACFs in Malaysia from September 2016 to April 2017. An exploratory qualitative study adhering to Consolidated Criteria for Reporting Qualitative Studies was conducted. In-depth interview was conducted with consent of all participants, and the interviews were audio recorded for later verbatim transcription. Observational analysis was also conducted in a noninterfering manner.
Three themes, namely medication use process, personnel handling medications and culture, emerged in this study. Medication use process highlighted an unclaimed liability for residents' medication by the RACFs, whereas personnel handling medications were found to lack sufficient training in medication management. Culture of the organization did affect the medication safety and quality improvement. The empowerment of the residents in their medication management was limited. There were unclear roles and responsibility of who manages the medication in the nongovernment-funded RACFs, although they were well structured in the private nursing homes.
There are important issues related to medication management in RACFs which require a need to establish policy and guidelines.
在全球范围内，老年人口数量正在上升。由于家庭负担着照顾老龄成员的高昂费用，对医疗保健和疗养院的需求不断增加。因此，药物管理对于确保护理中心的居民受益并协助护理中心管理以减轻医疗保健负担至关重要。本研究旨在定性探索老年护理机构（RACFs）中与药物管理相关的问题。
2016年9月至2017年4月，从马来西亚注册的政府、非政府组织和私立RACFs名单中招募了总共11名利益相关者，包括医疗保健提供者、管理人员、护理人员和居民。开展了一项遵循定性研究报告统一标准的探索性定性研究。在所有参与者同意的情况下进行了深入访谈，并对访谈进行了录音以便后续逐字转录。还以非干扰方式进行了观察分析。
本研究出现了三个主题，即用药过程、处理药物的人员和文化。用药过程突出了RACFs对居民药物的无人认领责任，而处理药物的人员被发现缺乏足够的药物管理培训。组织文化确实影响了药物安全和质量改进。居民在药物管理方面的自主权有限。在非政府资助的RACFs中，谁负责管理药物的角色和责任不明确，尽管在私立疗养院中它们结构完善。
RACFs中存在与药物管理相关的重要问题，需要制定政策和指南。
