| Status | 已發表Published |
| Key stakeholder perspectives on developing pharmaceutical care in nursing homes in Macao | |
Loi, C. I. ; Hu, H. ; Ung, O. L. C.
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| 2021-07-14 | |
| Source Publication | Shaping the future for health management education and research in a time of flux and uncertainty
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| Abstract | High rates of adverse drug events (ADEs) in nursing homes (NH) persist across the countries. It has been estimated that medication errors (MEs) occurred to 16–27% of residents and 75% of residents were prescribed with at least one potentially inappropriate medication.1 The vulnerability of NH residents is not surprising considering their comorbidities and complex drug regimens which increases the risks of drug–drug/disease interactions compounded by the age-related changes in physiology.2 Although the evidence about the benefits of PC in ensuring the appropriateness and safety of drug use in NH is moutning3,4, its introduction and development in NH lagged behind compared to other acute care settings.5 At present, the perceived needs for PC services by the key stakeholders in NH is underreported. This study aimed to explore the need for PC, key features of desirable PC, and perceived barriers for developing PC in NH. Semi-structured, in-depth interviews with 5 resident doctors, 7 pharmacy staff (pharmacists and pharmacy technicians), 19 nurses, 12 health assistants and 1 nutritionist employing purposive and snowballing sampling strategies were conducted in 10 out of the 11 subsidized NH in Macao between February and March 2021. The interview guide was informed by literature and comprised four domains: (1) perception of PC, (2) experiences of PC, (3) PC currently needed, and (4) barriers to the development of PC. The data were thematically coded and analyzed employing a framework approach. All participants perceived that PC in NH offered benefits to the doctors, nurses and residents. The level of PC varied across 3 different NH and the concept of PC in NH was insufficiently defined. In general, the scope of PC primarily consisted of management of pharmacy and medicine inventory, dispensing, providing drug-related advice to support medical decisions, providing basic drug knowledge to residents and their families, and advising nurses about preparing medicines such as when to crush tablets. Direct-to-resident care was rare. Specifically, doctors desired to acquire comprehensive drug information from and to share clinical responsibilities with pharmacists. Nurses wished to lower their burdens of medication management duties. Most commonly observed benefits of PH included: (1) decreased medication errors, (2) increased residents’ compliance, (3) alleviated workload for the frontline staff, and (4) raised awareness of drug-related problems and rational use of medicines. The listed barriers to PC included the lack of pharmacy workforce due to insufficient financial resources, the lack of physical space for pharmacy, insufficient accessibility to residents’ medical records by pharmacists, ambiguous role descriptions of pharmacist, and absence of effective communication between NH and other healthcare institutes to keep track of the residents’ health conditions. The development of PC has a significant effect on improving the quality use of medicine and supporting a multidisciplinary approach in the NH. Standardization of PC (including the level and firm of services and the mandate of pharmacy professionals) in NH is a key to generalize expectations from PC, monitor and evaluate the outcome, and develop evidence that support sustainable PC development. |
| Keyword | pharmaceutical care nursing home key stakeholder interview |
| Language | 英語English |
| The Source to Article | PB_Publication |
| PUB ID | 61008 |
| Document Type | Conference paper |
| Collection | Institute of Chinese Medical Sciences |
| Corresponding Author | Ung, O. L. C. |
| Recommended Citation GB/T 7714 | Loi, C. I.,Hu, H.,Ung, O. L. C.. Key stakeholder perspectives on developing pharmaceutical care in nursing homes in Macao[C], 2021. |
| APA | Loi, C. I.., Hu, H.., & Ung, O. L. C. (2021). Key stakeholder perspectives on developing pharmaceutical care in nursing homes in Macao. Shaping the future for health management education and research in a time of flux and uncertainty. |
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