1 / 28

Perspectives on Self-Administration of Medication in Hospital

A qualitative study exploring the perspectives of patients and healthcare providers regarding self-administration of medication in hospital and identifying adaptations required for implementation.

tfountain
Download Presentation

Perspectives on Self-Administration of Medication in Hospital

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Self-administration of medication in hospital: the perspectives of patients and health care providers Prof. dr. Tinne Dillesdra. Toke Vanwesemaelwww.NuPhaC.eu

  2. Introduction Health • “the ability to adapt and self-manage in the face of social, physical, and emotional changes”  SELF-MANAGEMENT • paternalistic approach  active partner in health and disease management Self-management of medication  The process in which patients prepare and consume medications themselves rather than a health professional taking over this role. Advantages: • Increased patient satisfaction • Improvement of adherence to pharmacotherapy • Improvement of self-care competences • Safety? • Time? Huber, 2011; Orem, 2001, Barnason, 2010; Bolster, 2010; Lam, 2011; Tran, 2011; Wright, 2006

  3. Belgium Prevalence of self-administration (1,269 hospitalized patients) • Actual prevalence • at least one medicine: 22% • >50% of medicines: 14% • All medicines: 6% • Potential prevalence • 41% would be able to fully self-administer (perspective nurses) Support (59 hospital departments) • 18 % has a procedure. • 7% has a screening tool

  4. Research aim To explore health care providers’ and patients’ perspectives concerning self-administration of medication whilst in hospital, and to describe adaptations required for implementation.

  5. Methodology Qualitative study • Descriptive research design (Sandelowski, 2000) • October 2014 – January 2015 • Random selected wards of 1 regional & 2 university hospitals • Purposive sampling strategy • Nurses, physicians, hospital pharmacists Exclusion: not directly involved in management of patients’ medication • Patients Exclusion: <18 years, mentally and/or physically not able to participate • Semi-structured interviews (SWOT – conditions) • Qualitative content analysis (Hsieh & Shannon, 2005)

  6. Qualitative descriptive design SWOT of self-management of medication

  7. Participants • 6 physicians; a pulmonologist, geriatricians, an endocrinologist, a cardiologist and a nephrologist. • 11 nurses; pulmonology-nephrology, gastro-oncology, geriatrics, general surgery, endocrinology, nephrology, neurology, gastroenterology and cardiology-nephrology • 6 hospital pharmacists; • 7 patients; gastro-oncology, pulmonology-nephrology, general surgery, endocrinology, nephrology, gastroenterology and cardiology-nephrology.

  8. Themes and subthemes

  9. S Benefits for patients

  10. S Benefits for nurses and collaboration

  11. W Disadvantages for patients

  12. W Disadvantages for professionals

  13. O Opportunities related to the patient

  14. O Opportunities related to the organisation and implementation

  15. T Obstacles related to the implementation

  16. T Obstacles related to the medication

  17. Conditions to allow self-management in hospital Patient: • Self-management before admission and after discharge • Patient is willing to self-manage and to take responsibility • Adequate mental and physical condition • Adequate knowledge about self-managed medication Medication: • Low risk medication • Regimen not to complex • No intravenous, intramuscular, subcutaneous medication Organisation: • Software to support self-management (overview, distinction, registration) • Clear legal context (responsibilities) • Monitoring system • Lockers for medication • Protocol and flow chart including medication logistics and interprofessional communication

  18. A quantitative survey desing Patients’ attitudes towardsself-management of medication

  19. Methodology Qualitative study • Cross-sectional observational study in 1 regional & 2 university hospitals (November-December 2015) Only results of patients are presented • Randomlyselectedwards, allhospitalizedpatients • Patients Exclusion: <18 years, mentally and/or physically not able to participate not present on the ward at the time of data collection, not Dutch speaking • Structured questionnaire

  20. Participants (n=124)

  21. Participants’ medicationuse at home (n=124)

  22. Patients not included in the study (n= 218)

  23. Willingness of patients to self-administer medication whilst in hospital

  24. Prerequisites for self-administration of medication (patients) Before I self-administer my medication during hospitalization, it is a prerequisite that … (n=103)

  25. Consequences of self-administration of medication (patients) Because of self-administration of medication in hospital… (n=113)

  26. Conclusions and Implications for practice • General perceptions on self-management were very positive • Some obstacles need to be resolved to facilitate implementation • Study provides knowledge about SWOT for self-management of medication in hospital concerning important stakeholders, required to • Develop toolbox to support self-management of medication • Develop a structured, safe and controllable procedure for self-management of medication • Improve the quality of self-management of medication in practice • Maximize the potential benefits of self-management of medication for patients • Test the effects of self-management of medication in hospitals in a quatitative experimental design

  27. References Barnason, S., Zimmerman, L., Hertzog, M., & Schulz, P. (2010). Pilot testing of a medication self-management transition intervention for heart failure patients. West J Nurs Res, 32(7), 849- 870. Bolster, D., & Manias, E. (2010). Person-centred interactions between nurses and patients during medication activities in an acute hospital setting: qualitative observation and interview study. Int J Nurs Stud, 47(2), 154-165. doi:10.1016/j.ijnurstu.2009.05.021 Huber, M., Knottnerus, J. A., Green, L., van der Horst, H., Jadad, A. R, Kromhout, D., Leonard, B., Lorig, K., Loureiro, M. I., van der Meer, J. W. M., Schnabel, P., Smith, R., van Weel, C., Smid, H. (2011). How should we define health? BMJ, 343. Lam, P., Elliott, R. A., & George, J. (2011). Impact of a self-administration of medications programme on elderly inpatients' competence to manage medications: a pilot study. J Clin Pharm Ther, 36(1), 80-86. Orem, D. E. (2001). Nursing: Concepts of practice. St. Louis, MO: Mosby. Tran, T., Elliott, R. A., Taylor, S. E., & Woodward, M. C. (2011). A Self-Administration of Medications Program to Identify and Address Potential Barriers to Adherence in Elderly Patients (January). Ann Pharmacother. doi: 10.1345/aph.1P473 Wright, J., Emerson, A., Stephens, M., & Lennan, E. (2006). Hospital inpatient self-administration of medicine programmes: a critical literature review. Pharm World Sci, 28(3), 140-151. SelfMED: Self-Administration of Medication in Hospital: A Prevalence Study in Flanders, Belgium. Vanwesemael T, Van Rompaey B, Petrovic M, Boussery K, Dilles T. J Nurs Scholarsh. 2017 May;49(3):277-285. doi: 10.1111/jnu.12290. Epub 2017 Apr 4 SelfMED: Self-management of medication during hospitalisation: health care providers’ and patients’ perspectivesVanwesemael T, Boussery K., Fraeyman J., Manias E., Dilles T. Submitted for publication

  28. www.NuPhaC.eu • https://pbs.twimg.com/media/BiEMmWYIcAA5js0.jpg

More Related