Deakin University, Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, Victoria, 3125, Australia.
Deakin University, Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, Victoria, 3125, Australia; Deakin-Alfred Health Nursing Research Centre, Alfred Health, 55 Commercial Rd, Melbourne, VIC 3004 Australia.
Res Social Adm Pharm. 2021 Feb;17(2):273-291. doi: 10.1016/j.sapharm.2020.03.023. Epub 2020 Apr 6.
Communication about managing medications may be difficult when older people move across transitions of care. Communication breakdowns may result in medication discrepancies or incidents.
The aim of this systematic review was to explore older patients' experiences and perceptions of communication about managing medications across transitions of care.
A systematic review.
A comprehensive review was conducted of qualitative, quantitative and mixed method studies using CINAHL Complete, MEDLINE, Embase and PsycINFO, Web of Science, INFORMIT and Scopus. These databases were searched from inception to 14.12.2018. Key article cross-checking and hand searching of reference lists of included papers were also undertaken.
studies of the medication management perspectives of people aged 65 or older who transferred between care settings. These settings comprised patients' homes, residential aged care and acute and subacute care. Only English language studies were included. Comments, case reports, systematic reviews, letters, editorials were excluded. Thematic analysis was undertaken by synthesising qualitative data, whereas quantitative data were summarised descriptively. Methodological quality was assessed with the Mixed Methods Appraisal Tool.
The final review comprised 33 studies: 12 qualitative, 17 quantitative and 4 mixed methods studies. Twenty studies addressed the link between communication and medication discrepancies; ten studies identified facilitators of self-care through older patient engagement; 18 studies included older patients' experiences with health professionals about their medication regimen; and, 13 studies included strategies for communication about medications with older patients. Poor communication between primary and secondary care settings was reported as a reason for medication discrepancy before discharge. Older patients expected ongoing and tailored communication with providers and timely, accurate and written information about their medications before discharge or available for the post-discharge period.
Communication about medications was often found to be ineffective. Most emphasis was placed on older patients' perspectives at discharge and in the post-discharge period. There was little exploration of older patients' views of communication about medication management on admission, during hospitalisation, or transfer between settings.
老年人在跨过渡护理时，管理药物的沟通可能会很困难。沟通不畅可能导致药物差异或事件。
本系统评价旨在探讨老年患者在跨过渡护理时管理药物的沟通体验和看法。
系统评价。
使用 CINAHL Complete、MEDLINE、Embase 和 PsycINFO、Web of Science、INFORMIT 和 Scopus 全面检索了定性、定量和混合方法研究。这些数据库从一开始就被搜索到 2018 年 12 月 14 日。还对纳入论文的参考文献进行了关键文章交叉检查和手工搜索。
在护理环境之间转移的年龄在 65 岁或以上的人对药物管理的观点研究。这些环境包括患者的家庭、养老院和急性和亚急性护理。仅包括英语研究。评论、案例报告、系统评价、信件、社论被排除在外。通过综合定性数据进行主题分析，而定量数据则进行描述性总结。使用混合方法评估工具评估方法学质量。
最终审查包括 33 项研究：12 项定性研究、17 项定量研究和 4 项混合方法研究。20 项研究探讨了沟通与药物差异之间的联系；10 项研究确定了通过老年患者参与自我护理的促进因素；18 项研究包括老年患者对其药物治疗方案与卫生专业人员的经验；13 项研究包括与老年患者沟通药物的策略。出院前初级和二级保健机构之间沟通不畅被报道为药物差异的原因。老年患者期望在出院前与提供者进行持续、量身定制的沟通，并及时、准确地提供关于他们的药物的书面信息，或在出院后提供。
药物沟通通常被认为是无效的。最强调的是出院时和出院后老年患者的观点。很少有研究探索老年患者在入院、住院期间或在过渡期间对药物管理沟通的看法。
