Pereira, Filipa; Meyer-Massetti, Carla; Del Río Carral, María; von Gunten, Armin; Wernli, Boris; Verloo, Henk (2023). Development of a patient-centred medication management model for polymedicated home-dwelling older adults after hospital discharge: results of a mixed methods study. BMJ open, 13(9), e072738. BMJ Publishing Group 10.1136/bmjopen-2023-072738
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OBJECTIVE
This study aimed to investigate medication management among polymedicated, home-dwelling older adults after discharge from a hospital centre in French-speaking Switzerland and then develop a model to optimise medication management and prevent adverse health outcomes associated with medication-related problems (MRPs).
DESIGN
Explanatory, sequential, mixed methods study based on detailed quantitative and qualitative findings reported previously.
SETTING
Hospital and community healthcare in the French-speaking part of Switzerland.
PARTICIPANTS
The quantitative strand retrospectively examined 3 years of hospital electronic patient records (n=53 690 hospitalisations of inpatients aged 65 years or older) to identify the different profiles of those at risk of 30-day hospital readmission and unplanned nursing home admission. The qualitative strand explored the perspectives of older adults (n=28), their informal caregivers (n=17) and healthcare professionals (n=13) on medication management after hospital discharge.
RESULTS
Quantitative results from older adults' profiles, affected by similar patient-related, medication-related and environment-related factors, were enhanced and supported by qualitative findings. The combined findings enabled us to design an interprofessional, collaborative medication management model to prevent MRPs among home-dwelling older adults after hospital discharge. The model comprised four interactive fields of action: listening to polymedicated home-dwelling older adults and their informal caregivers; involving older adults and their informal caregivers in shared, medication-related decision-making; empowering older adults and their informal caregivers for safe medication self-management; optimising collaborative medication management practices.
CONCLUSION
By linking the retrospective and prospective findings from our explanatory sequential study involving multiple stakeholders' perspectives, we created a deeper comprehension of the complexities and challenges of safe medication management among polymedicated, home-dwelling older adults after their discharge from hospital. We subsequently designed an innovative, collaborative, patient-centred model for optimising medication management and preventing MRPs in this population.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM) 04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine |
UniBE Contributor: |
Meyer-Massetti, Carla Verena |
Subjects: |
300 Social sciences, sociology & anthropology > 360 Social problems & social services 600 Technology > 610 Medicine & health |
ISSN: |
2044-6055 |
Publisher: |
BMJ Publishing Group |
Funders: |
[4] Swiss National Science Foundation |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
26 Sep 2023 10:12 |
Last Modified: |
03 Oct 2023 15:23 |
Publisher DOI: |
10.1136/bmjopen-2023-072738 |
PubMed ID: |
37730411 |
Uncontrolled Keywords: |
aging geriatric medicine patient-centered care primary care primary health care |
BORIS DOI: |
10.48350/186445 |
URI: |
https://boris.unibe.ch/id/eprint/186445 |
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