School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.
Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.
J Eval Clin Pract. 2021 Dec;27(6):1252-1261. doi: 10.1111/jep.13551. Epub 2021 Feb 15.
RATIONALE, AIMS, AND OBJECTIVES: Caregivers of people living with dementia play an essential role in managing medications across transitions of care. Adequate caregiver medication management guidance at hospital discharge is important to ensure optimal outcomes from medication use. This qualitative study explores the experiences and perspectives of caregivers about the medication management guidance provided at hospital discharge.
A qualitative approach using semi-structured, telephone interviews was conducted with 31 caregivers of people with dementia across Australia. Purposive sampling was used to ensure maximum variation of diverse experiences and perspectives.
Caregivers' experiences of medication guidance for people with dementia at discharge were described in three themes including: (a) inadequate information about medication management at discharge; (b) limited caregiver engagement in medication management decisions; and (c) difficulties ensuring medication supply post discharge. Most participants indicated they would like to be included in discussions at discharge. However, participation was influenced by caregivers being overwhelmed by discharge processes; proactively seeking information on medication-related harm; and belief in advocacy as part of their caregiver role. Caregivers reported they would like to receive a tailored medication list for people with dementia which included information on medications that may impact on the patient's cognition, and for hospital staff to communicate with both the community pharmacist and primary care physician, to improve co-ordination post transition.
In our study of caregivers of people with dementia, we identified key recommendations to facilitate regular participation of people living with dementia and their caregiver around medication guidance at discharge.
背景、目的和目标：痴呆症患者的护理人员在跨护理过渡期间管理药物方面发挥着重要作用。在出院时提供充分的护理人员药物管理指导对于确保药物使用的最佳结果非常重要。本定性研究探讨了护理人员对出院时提供的药物管理指导的经验和看法。
使用半结构式电话访谈，对澳大利亚各地的 31 名痴呆症患者的护理人员进行了定性研究。采用目的性抽样，以确保各种经验和观点的最大变化。
护理人员对出院时痴呆症患者药物管理指导的体验被描述为三个主题：（a）出院时关于药物管理的信息不足；（b）护理人员参与药物管理决策的程度有限；以及（c）出院后确保药物供应的困难。大多数参与者表示，他们希望参与出院时的讨论。然而，参与受到护理人员因出院程序而不知所措；积极寻求与药物相关的伤害的信息；以及作为他们护理人员角色的一部分的倡导信念的影响。护理人员报告说，他们希望收到一份针对痴呆症患者的个性化药物清单，其中包括可能影响患者认知功能的药物信息，并希望医院工作人员与社区药剂师和初级保健医生沟通，以改善过渡后的协调。
在我们对痴呆症患者护理人员的研究中，我们确定了一些关键建议，以促进痴呆症患者及其护理人员在出院时定期参与药物指导。
