New York University, New York, NY, USA.
Visiting Nurse Service of New York, New York, NY, USA.
Med Care Res Rev. 2020 Dec;77(6):609-619. doi: 10.1177/1077558719828942. Epub 2019 Feb 7.
A primary service provided by home care is medication management. Issues with medication management at home place older adults at high risk for hospital admission, readmission, and adverse events. This study sought to understand medication management challenges from the home care provider perspective. A qualitative secondary data analysis approach was used to analyze program evaluation interview data from an interprofessional educational intervention study designed to decrease medication complexity in older urban adults receiving home care. Directed and summative content analysis approaches were used to analyze data from 90 clinician and student participants. Medication safety issues along with provider-provider communication problems were central themes with medication complexity. Fragmented care coordination contributed to medication management complexity. Patient-, provider-, and system-level factors influencing medication complexity and management were identified as contributing to both communication and coordination challenges.
家庭护理提供的主要服务之一是药物管理。家庭药物管理方面存在的问题使老年人面临住院、再次入院和不良事件的高风险。本研究旨在从家庭护理提供者的角度了解药物管理方面的挑战。采用定性二次数据分析方法，对旨在减少接受家庭护理的老年城市成年人药物复杂性的跨专业教育干预研究的方案评估访谈数据进行分析。采用定向和总结性内容分析方法，对 90 名临床医生和学生参与者的数据进行分析。药物安全问题以及提供者之间的沟通问题是与药物复杂性相关的核心主题。分散的护理协调导致药物管理的复杂性。影响药物复杂性和管理的患者、提供者和系统层面的因素被认为是导致沟通和协调挑战的原因。
