Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.
PLoS One. 2024 Oct 31;19(10):e0310323. doi: 10.1371/journal.pone.0310323. eCollection 2024.
Adults with spinal cord injury/dysfunction (SCI/D) face challenges with medications they take to manage their secondary conditions (e.g., pain, urinary tract infections, autonomic dysreflexia). With many healthcare providers typically involved in care, there are additional challenges with care fragmentation and self-management. Prior research emphasized the desire for more support with medication self-management among this population.
To explore what content should be included in a medication self-management resource (i.e., toolkit) for adults with SCI/D, as well as considerations for delivery from the perspectives of adults with SCI/D, caregivers, healthcare providers, and representatives from community organizations.
A concept mapping study was conducted. Participants took part in one or more of three activities: brainstorming; sorting and rating; and mapping. Participants generated ideas about the content to include in a medication self-management toolkit. Participants sorted the statements into conceptual piles and assigned a name to each. All statements were rated on a five-point Likert-type scale on importance and realistic to include in the toolkit. Participants decided on the final cluster map, rearranged statements, and assigned a name to each cluster to create visual representations of the data.
Forty-four participants took part in this study. The final map contained eight clusters: 1) information-sharing and communication; 2) healthcare provider interactions and involvement; 3) peer and community connections; 4) supports and services for accessing prescription medications and medication information; 5) information on non-prescription medication and medication supplies; 6) safety and lifestyle considerations; 7) general medication information; and 8) practical information and strategies related to medication-taking. Safety and lifestyle considerations was rated as the most important and realistic to include in the toolkit.
Given the limited tools to help adults with SCI/D with managing their medications, there is great potential to better support this population across all areas of medication self-management.
患有脊髓损伤/功能障碍（SCI/D）的成年人在管理其继发性疾病（如疼痛、尿路感染、自主反射异常）的药物方面面临挑战。由于通常有许多医疗保健提供者参与护理，因此在护理碎片化和自我管理方面还存在其他挑战。先前的研究强调了这一人群对药物自我管理方面更多支持的需求。
探索应包含在 SCI/D 成年人药物自我管理资源（即工具包）中的内容，以及从 SCI/D 成年人、护理人员、医疗保健提供者和社区组织代表的角度考虑交付方式。
进行了概念映射研究。参与者参加了以下一项或多项活动：头脑风暴；分类和评分；以及映射。参与者提出了有关包含在药物自我管理工具包中的内容的想法。参与者将陈述分类到概念堆中，并为每个堆分配一个名称。所有陈述都在五分制李克特量表上进行了重要性和现实性评分，以确定是否包含在工具包中。参与者决定最终的聚类图，重新排列陈述，并为每个聚类分配一个名称，以创建数据的可视化表示。
共有 44 名参与者参加了这项研究。最终的图谱包含八个聚类：1）信息共享和沟通；2）医疗保健提供者的互动和参与；3）同伴和社区联系；4）获取处方药和药物信息的支持和服务；5）非处方药和药物供应信息；6）安全和生活方式考虑；7）一般药物信息；以及 8）与服药相关的实用信息和策略。安全和生活方式考虑被评为最重要和最现实的内容，应包含在工具包中。
鉴于帮助 SCI/D 成年人管理药物的工具有限，因此有很大的潜力可以在药物自我管理的所有领域为这一人群提供更好的支持。
