Breen Juanita L, Williams Kathleen V, Wroth Melanie J
Clinical Pharmacy Unit, Aged Care Quality and Safety Commission, Canberra, ACT 2601, Australia.
Wicking Dementia Centre, College of Health and Medicine, University of Tasmania, Hobart, TAS 7001, Australia.
Pharmacy (Basel). 2023 Mar 23;11(2):63. doi: 10.3390/pharmacy11020063.
Complaints reflect a person's or family's experience within the aged care system and provide important insight into community expectations and consumer priorities. Crucially, when aggregated, complaints data can serve to indicate problematic trends in care provision. Our objective was to characterize the areas of medication management most frequently complained about in Australian residential aged care services from 1 July 2019 to 30 June 2020. A total of 1134 complaint issues specifically referenced medication use. Using content analysis, with a dedicated coding framework, we found that 45% of these complaints related to medicine administration processes. Three categories received nearly two thirds of all complaints: (1) not receiving medication at the right time; (2) inadequate medication management systems; and (3) chemical restraint. Half of the complaints described an indication for use. These were, in order of frequency: 'pain management', 'sedation', and 'infectious disease/infection control'. Only 13% of medication-related complaints referred to a specific pharmacological agent. Opioids were the most common medication class referred to in the complaint dataset, followed by psychotropics and insulin. When compared to complaint data composition overall, a higher proportion of anonymous complaints were made about medication use. Residents were significantly less likely to lodge complaints about medication management, probably due to limited engagement in this part of clinical care provision.
投诉反映了个人或家庭在老年护理系统中的经历，并为了解社区期望和消费者优先事项提供了重要见解。至关重要的是，汇总后的投诉数据可用于指出护理提供方面的问题趋势。我们的目标是描述2019年7月1日至2020年6月30日期间澳大利亚老年护理机构中最常被投诉的药物管理领域。共有1134个投诉问题特别提到了药物使用情况。通过使用内容分析法和专门的编码框架，我们发现其中45%的投诉与给药过程有关。所有投诉中有近三分之二集中在三个类别：（1）未在正确时间服药；（2）药物管理系统不完善；（3）化学约束。一半的投诉描述了使用指征。按频率排序依次为：“疼痛管理”、“镇静”和“传染病/感染控制”。只有13%的与药物相关的投诉提到了特定的药物制剂。阿片类药物是投诉数据集中提及最多的药物类别，其次是精神药物和胰岛素。与总体投诉数据构成相比，关于药物使用的匿名投诉比例更高。居民对药物管理提出投诉的可能性显著较低，这可能是由于他们在这部分临床护理提供中的参与度有限。
