Lynnerup Camilla, Rossing Charlotte, Sodemann Morten, Ryg Jesper, Pottegård Anton, Nielsen Dorthe
Migrant Health Clinic - Research Unit for Infectious Diseases, Odense University Hospital, Odense C, Denmark.
Centre for Global Health, University of Southern Denmark, Odense C, Denmark.
Explor Res Clin Soc Pharm. 2022 Mar 17;5:100128. doi: 10.1016/j.rcsop.2022.100128. eCollection 2022 Mar.
Older migrants with cognitive impairment exposed to polypharmacy constitute a vulnerable group of patients. To our knowledge, evidence on medication safety among this patient group with multiple risk factors is lacking.
To explore the perspectives of health care professionals on medication safety among older migrants with cognitive impairment taking five or more medications daily.
A total of 34 health care professionals (general practitioners and hospital-, community pharmacy-, and home care staff) participated in the study, comprising nine focus groups and one semi-structured interview, and shared their perspectives on medication safety among older migrants with cognitive impairment exposed to polypharmacy. The analysis was inspired by Revsbæk and Tanggaard's "Analyzing in the Present" and was followed by systematic text condensation.
Three main themes emerged: (i) the importance of relationships in medication safety, (ii) culture and finances as risk factors, and (iii) the health care system as a risk factor. Subthemes and codes were related within and across main themes and revealed a high level of complexity within the barriers to medication safety. Some of these barriers were closely related to characteristics of this specific patient group, while others were more general barriers that also affected other patient groups. Participants found that these more general problems were complicated further by language barriers and cognitive impairment when working with this patient group.
Health care professionals across various sectors and professions experienced several barriers that threatened medication safety among older migrants with cognitive impairment exposed to polypharmacy. Closer collaboration between health care professionals, patients, and relatives is required to improve medication safety.
认知功能受损的老年移民且服用多种药物，构成了一个脆弱的患者群体。据我们所知，缺乏关于这一具有多种风险因素的患者群体用药安全的证据。
探讨医疗保健专业人员对每天服用五种或更多药物的认知功能受损老年移民用药安全的看法。
共有34名医疗保健专业人员（全科医生、医院、社区药房和家庭护理人员）参与了该研究，包括九个焦点小组和一次半结构化访谈，他们分享了对认知功能受损且服用多种药物的老年移民用药安全的看法。分析受到Revsbæk和Tanggaard的“当下分析”的启发，并随后进行了系统的文本浓缩。
出现了三个主要主题：（i）用药安全中关系的重要性，（ii）文化和财务作为风险因素，以及（iii）医疗保健系统作为风险因素。子主题和编码在主要主题内部和之间相互关联，揭示了用药安全障碍中的高度复杂性。其中一些障碍与这一特定患者群体的特征密切相关，而其他则是更普遍的障碍，也影响其他患者群体。参与者发现，在与该患者群体合作时，这些更普遍的问题因语言障碍和认知功能受损而进一步复杂化。
各个部门和专业的医疗保健专业人员都经历了一些威胁到认知功能受损且服用多种药物的老年移民用药安全的障碍。医疗保健专业人员、患者和亲属之间需要更密切的合作以提高用药安全。
