Stewart Derek, Gibson Smith Kathrine, MacLeod Joan, Strath Alison, Paudyal Vibhu, Forbes-McKay Katrina, Cunningham Scott, MacLure Katie
Robert Gordon University, Aberdeen, Scotland, UK.
University of Birmingham, Birmingham, England, UK.
Int J Clin Pharm. 2018 Apr;40(2):394-402. doi: 10.1007/s11096-017-0580-x. Epub 2018 Jan 13.
Background Multi-compartment compliance aids (MCAs) are promoted as a potential solution to medicines non-adherence despite the absence of high quality evidence of effectiveness of MCA use impacting medicines adherence or any clinical outcomes. Furthermore, there is a lack of qualitative research which focuses on the perspectives of older people receiving MCAs. Objectives To describe experiences and beliefs surrounding very sheltered housing (VSH) residents' use of MCAs with emphasis on issues of personalisation, reablement, shared decision-making, independence and support. Setting VSH in north east Scotland. Methods Qualitative, face-to-face interviews with 20 residents (≥ 65 years, using MCA > 6 months) in three VSH complexes. Interviews focused on: when and why the MCA was first introduced; who was involved in making that decision; how the MCA was used; perceptions of benefit; and any difficulties encountered. Interviews were audiorecorded, transcribed and analysed using a framework approach. Main outcome measure Experiences and beliefs surrounding use of MCAs. Results Nine themes were identified: shared decision-making; independence; knowledge and awareness of why MCA had been commenced; support in medicines taking; knowledge and awareness of medicines; competent and capable to manage medicines; social aspects of carers supporting MCA use; benefits of MCAs; and drawbacks. Conclusion Experiences and beliefs are diverse and highly individual, with themes identified aligning to key strategies and policies of the Scottish Government, and other developed countries around the world, specifically personalisation shared decision making, independence, reablement and support.
背景 多隔层依从性辅助工具(MCAs)被宣传为解决药物不依从问题的一种潜在方法,尽管缺乏高质量证据表明使用MCAs能影响药物依从性或任何临床结果。此外,缺乏聚焦于接受MCAs的老年人观点的定性研究。目的 描述极庇护性住房(VSH)居民使用MCAs的经历和信念,重点关注个性化、恢复能力、共同决策、独立性和支持等问题。地点 苏格兰东北部的VSH。方法 对三个VSH小区的20名居民(≥65岁,使用MCAs超过6个月)进行定性面对面访谈。访谈重点包括:MCAs首次引入的时间和原因;谁参与了该决策;MCAs的使用方式;对益处的看法;以及遇到的任何困难。访谈进行录音、转录,并采用框架方法进行分析。主要结局指标 围绕使用MCAs的经历和信念。结果 确定了九个主题:共同决策;独立性;对开始使用MCAs原因的知识和认识;服药方面的支持;对药物的知识和认识;有能力管理药物;护理人员支持使用MCAs的社会方面;MCAs的益处;以及缺点。结论 经历和信念各不相同且高度个体化,所确定的主题与苏格兰政府以及世界其他发达国家的关键战略和政策相一致,特别是个性化、共同决策、独立性、恢复能力和支持。