Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.
BMJ Open. 2022 May 2;12(5):e058237. doi: 10.1136/bmjopen-2021-058237.
Medication management guidance for carers of people with dementia at hospital discharge is important to prevent medication-related harm during transitions of care. This study aimed to develop a tool to evaluate medication management guidance provided to carers of people with dementia at hospital discharge.
The tool was developed using mixed methods involving two stages. Stage 1 involved item generation and content validation. Items were based on a previous qualitative study and systematic review. Content validation involved experts and consumers with knowledge or experience of medication management guidance in the acute care setting, and rating each item on importance and relevance. Stage 2 involved conducting cognitive interviews with carers of people with dementia to pretest the tool.
For stage 1, experts and consumers from Australia, USA and New Zealand were included. For stage 2, carers of people with dementia were recruited across Australia.
18 experts and consumers participated in round 1 of content validation, and 13 experts and consumers completed round 2. Five carers of people with dementia participated in cognitive interviews.
The final tool contained 30 items capturing information across five domains: (1) provision of medication management guidance at hospital discharge; (2) carer understanding of medication management guidance provided at discharge; (3) carer engagement in discussing the safe use of medications at discharge; (4) carer preparedness to conduct medication management activities after discharge; and (5) co-ordination of medication management guidance after discharge.
We developed the first tool to assess medication management guidance provided for carers of people with dementia at hospital discharge. The tool may be useful to inform future research strategies to improve the delivery of medication management guidance at discharge.
为了防止痴呆患者在出院过渡期间发生与药物相关的伤害，为照护者提供有关痴呆患者出院时药物管理的指导非常重要。本研究旨在开发一种工具，以评估为痴呆患者出院时的照护者提供的药物管理指导。
该工具采用混合方法开发，包括两个阶段。第 1 阶段涉及项目生成和内容验证。项目基于之前的定性研究和系统评价。内容验证涉及在急性护理环境中具有药物管理指导知识或经验的专家和消费者，对每个项目的重要性和相关性进行评分。第 2 阶段涉及对痴呆患者的照护者进行认知访谈，以预测试具。
第 1 阶段包括来自澳大利亚、美国和新西兰的专家和消费者。第 2 阶段在澳大利亚招募了痴呆患者的照护者。
18 名专家和消费者参加了第 1 轮内容验证，13 名专家和消费者完成了第 2 轮。5 名痴呆患者的照护者参加了认知访谈。
最终工具包含 30 个项目，涵盖五个领域的信息：（1）在出院时提供药物管理指导；（2）照护者对出院时提供的药物管理指导的理解；（3）照护者在出院时参与讨论安全使用药物；（4）照护者准备在出院后进行药物管理活动；（5）出院后药物管理指导的协调。
我们开发了第一个评估为痴呆患者出院时的照护者提供的药物管理指导的工具。该工具可能有助于为未来的研究策略提供信息，以改善出院时药物管理指导的提供。
