Medicine Optimisation Research Group, School of Pharmacy and Medical Sciences, University of Bradford, Bradford, UK.
Medicine Management and Pharmacy Services, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Health Expect. 2020 Dec;23(6):1603-1613. doi: 10.1111/hex.13145. Epub 2020 Oct 16.
Multiple changes are made to older patients' medicines during hospital admission, which can sometimes cause confusion and anxiety. This results in problems with post-discharge medicines management, for example medicines taken incorrectly, which can lead to harm, hospital readmission and reduced quality of life.
To explore the experiences of older patients and their family carers as they enacted post-discharge medicines management.
Semi-structured interviews took place in participants' homes, approximately two weeks after hospital discharge. Data analysis used the Framework method.
Recruitment took place during admission to one of two large teaching hospitals in North England. Twenty-seven participants aged 75 plus who lived with long-term conditions and polypharmacy, and nine family carers, were interviewed.
Three core themes emerged: impact of the transition, safety strategies and medicines management role. Conversations between participants and health-care professionals about medicines changes often lacked detail, which disrupted some participants' knowledge and medicines management capabilities. Participants used multiple strategies to support post-discharge medicines management, such as creating administration checklists, seeking advice or supporting primary care through prompts to ensure medicines were supplied on time. The level to which they engaged with these activities varied.
Participants experienced gaps in their post-discharge medicines management, which they had to bridge through implementing their own strategies or by enlisting support from others. Areas for improvement were identified, mainly through better communication about medicines changes and wider involvement of patients and family carers in their medicines-related care during the hospital-to-home transition.
在住院期间，会对老年患者的药物进行多项调整，这有时会导致混淆和焦虑。这会导致出院后药物管理出现问题，例如药物使用不当，从而导致伤害、再次住院和生活质量下降。
探讨老年患者及其家庭照顾者在执行出院后药物管理时的体验。
在参与者家中进行半结构式访谈，大约在出院后两周进行。数据分析使用框架方法。
在英格兰北部的两家大型教学医院之一的住院期间进行招募。共有 27 名年龄在 75 岁及以上、患有长期疾病和多种药物的患者和 9 名家庭照顾者接受了采访。
出现了三个核心主题：过渡的影响、安全策略和药物管理角色。患者与医疗保健专业人员关于药物变化的讨论往往缺乏细节，这扰乱了一些患者的知识和药物管理能力。参与者使用多种策略来支持出院后的药物管理，例如创建管理清单、寻求建议或通过提示来支持初级保健，以确保按时供应药物。他们参与这些活动的程度各不相同。
参与者在出院后的药物管理方面存在差距，他们必须通过实施自己的策略或通过让其他人参与来弥补这些差距。确定了需要改进的领域，主要是通过更好地沟通药物变化以及更广泛地让患者和家庭照顾者参与他们在从医院到家庭过渡期间的药物护理。
