SARAH THELIN: Preventing drug-related problems – various stakeholders’ contributions to enhanced medication safety

Project description

Background

The municipal care staff, often nursing assistants, supports elderly with their medication management. The care staff are crucial in identifying and addressing potential DRPs, a task requiring proper training. Treating physicians, are in addition to their responsibility of prescribing and following up on medications, responsible for ensuring accurate and updated medication lists. Studies have shown that discrepancies in medication lists are a significant problem in both inpatient and primary care, causing DRPs. Nurses are the core of the elderly care clinics in primary care, which have been gradually introduced in several regions over the past decade. These clinics can assist with many critical issues for the elderly patient, including follow-up after hospital care and medication-related concerns. The patients themselves also have a role in preventing medication-related risks. Over-the-counter medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), pose risks for the elderly, potentially causing ulcers, kidney failure, heart failure, or heart attacks. Sufficient knowledge among patients about safe medication use is essential.

Aim

To explore the contributions and responsibilities of various stakeholders in the safety of medication management in the elderly from four different perspectives.

• Study 1 explores nursing assistants' roles in managing and preventing DRPs using a mixed method involving a quantitative survey and qualitative semi-structured interviews with nursing assistants in nursing homes in Region Skåne. The study analyses descriptive statistics and uses qualitative content analysis.
• Study 2 examines the attitudes of primary care physicians in Region Skåne towards managing medication lists through a survey based on the Theory of Planned Behavior. The study validates the survey and after distribution analyses the relationship between predictors of behaviour and the intention to perform medication reconciliations.
  
  
• Study 3 highlights nurses' work with DRPs through focus group interviews with nurses in elderly care clinics in Region Skåne and Region Östergötland. The study uses qualitative content analysis.
  
  
• Studies 4 and 5 investigate patients' own role in preventing DRPs. Study 4 explores the awareness of NSAID risks among the elderly who buy NSAIDs over-the-counter through a survey. The survey addresses self-reported medication use and risk diagnoses as well as knowledge of risks.
  
  
• Study 5 examines the use of NSAIDs over time among the elderly and the relationship between risk diagnoses and NSAID consumption through data from the cohort Good Aging in Skåne.

Relevance

Reducing DRPs is primarily important for the health and quality of life of elderly individuals, but also for society in reducing costs for unnecessary healthcare consumption. By targeting the various stakeholders involved in medication treatment, DRPs, particularly side effects, can be prevented.