Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.
Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
BMC Geriatr. 2024 Jun 14;24(1):520. doi: 10.1186/s12877-024-05124-9.
Dementia is a major global public health challenge, and with the growing elderly population, its prevalence is expected to increase in the coming years. In Sweden, municipalities are responsible for providing special housing for the elderly (SÄBO), which offers services and care for older individuals needing specific support. SÄBO is both the person´s home and a care environment and workplace. Polypharmacy in patients with dementia is common and increases the risk of medication interactions. Involving clinical pharmacists in medication reviews has been shown to enhance medication safety and improve prescribing practices. However, the views of the standard care team involved in medication prescribing, administration, monitoring and documentation on integrating pharmacist services have received less attention. Thus, this study aims to explore how pharmacists' contributions can enhance medication safety, improve patient care efficiency, and potentially alleviate the workload of general practitioners for people with dementia living in special housing.
This study has a descriptive qualitative study design using semi-structured interviews and qualitative content analysis. The study was conducted in a southern Swedish special housing and included nurses, assistant nurses, general practitioners (GPs), and a pharmacist. Due to the COVID-19 pandemic, interviews were conducted over the phone. The Swedish Ethical Review Authority approved the study.
The analysis revealed three main categories, and eleven subcategories.: (1) Integrating multidisciplinary approaches for holistic dementia care, (2) Strengthening dementia care through effective medication management and (3) Advancing dementia care through pharmacist integration and role expansion. Nurses focused on non-pharmacological treatments, while GPs emphasized the importance of medication reviews in assessing the benefits and side-effects of prescribed medication. Pharmacists were valued for their reliable medication expertise, appreciated by GPs for saving time and providing recommendations prior to consultations with individuals with dementia and their next-of-kin. Although medication reviews were considered beneficial, there was skepticism about their ability to solve all medication-related problems associated with dementia care.
This study highlights the critical role pharmacists play in enhancing medication safety and patient care efficiency in special housing for individuals with dementia. Despite the value of their contributions, communication barriers within healthcare teams pose significant challenges. Recognising potential pharmacist role expansion is essential to alleviate the workload of GPs and ensure effective collaborative practices for better patient outcomes.
痴呆症是一个重大的全球公共卫生挑战，随着老年人口的增长，预计在未来几年其患病率将会增加。在瑞典，市政府负责为老年人提供特殊住房（SÄBO），为需要特定支持的老年人提供服务和护理。SÄBO 既是老年人的家，也是一个护理环境和工作场所。痴呆症患者普遍存在多重用药的情况，这增加了药物相互作用的风险。让临床药师参与药物审查已被证明可以提高药物安全性并改善处方实践。然而，参与药物开方、管理、监测和记录的标准护理团队对整合药师服务的看法受到的关注较少。因此，本研究旨在探讨药师的贡献如何能够提高药物安全性、提高患者护理效率，并可能减轻居住在特殊住房中的痴呆症患者的全科医生的工作量。
本研究采用描述性定性研究设计，使用半结构式访谈和定性内容分析。该研究在瑞典南部的一个特殊住房中进行，包括护士、助理护士、全科医生（GP）和药剂师。由于 COVID-19 大流行，访谈是通过电话进行的。瑞典伦理审查局批准了这项研究。
分析揭示了三个主要类别和十一个子类别：（1）整合多学科方法进行整体痴呆症护理，（2）通过有效的药物管理加强痴呆症护理，（3）通过药剂师整合和角色扩展推进痴呆症护理。护士专注于非药物治疗，而全科医生则强调药物审查在评估规定药物的益处和副作用方面的重要性。药剂师因其可靠的药物专业知识而受到重视，他们在与痴呆症患者及其近亲进行咨询之前提供建议，这为全科医生节省了时间。虽然药物审查被认为是有益的，但有人怀疑它们是否能够解决与痴呆症护理相关的所有药物相关问题。
本研究强调了药剂师在提高特殊住房中痴呆症患者药物安全性和患者护理效率方面的关键作用。尽管他们的贡献具有价值，但医疗保健团队内部的沟通障碍仍然是一个重大挑战。认识到潜在的药剂师角色扩展对于减轻全科医生的工作量和确保有效的协作实践以实现更好的患者结果至关重要。
