Patient Preference and Adherence (Jun 2018)
Medication practices and experiences of older adults discharged home from hospital: a feasibility study protocol
Abstract
Pauline Roux,1 Filipa Pereira,2 Marie Santiago-Delefosse,1 Henk Verloo2 1University of Lausanne, Institute of Psychology, Research Center for Psychology of Health, Aging and Sport Examination, Lausanne, Switzerland; 2University of Applied Sciences and Arts Western Switzerland, Department of Nursing Sciences, Sion, Switzerland Background: Switzerland’s aging population raises pressing questions about maintaining older adults in their home environments and the problems associated with managing complex treatments requiring medication in such contexts. Few studies have examined older adults’ experiences of changes in their medication on discharge home following hospitalization for illness or an accident. Similarly, few studies have evaluated the involvement of informal and professional caregivers in the medication practices used with older adults living at home. However, medication practices are complex and understanding them requires an interest in their underlying logic and the interactions that constitute them. This study will explore the feasibility of recruiting older adults and then collecting and analyzing data on their medication practices and their experiences of discharge home after hospitalization for an illness or following an accident. Furthermore, it will describe the involvement of informal caregivers and homecare professionals in these processes.Design and methods: The study will use a qualitative methodology. The first phase will be developed in the general medicine and surgery wards of Sion hospital and in the town’s community healthcare center. This phase will aim to build a close collaboration between the research team and the health care professionals of Valais hospitals and the community healthcare center. It will enable data collection from professional caregivers to identify the tools, and potentially the interventions, which are used to prepare older adults for hospital discharge and return home, particularly with regard to the medication prescribed to them. In the second phase, semi-structured interviews will be conducted with eight patients aged 75 years old or more who have returned home after hospitalization. Interviews will also be conducted with their informal and professional caregivers.Conclusion: This feasibility study will enable the identification of tools that leverage improved adhesion to a medical treatment that has been adjusted and stabilized following discharge home from hospital. It will incorporate the points of view of older adults and the different stakeholders involved in the management of their medication and the development of tangible solutions to encourage treatment adhesion on discharge home. This study’s findings will enable us to design a much larger future study. Keywords: medication practices, experiences, older adults, discharge home, informal caregivers, homecare professionals, primary care, home dwelling older adults, home care, nurses, family physician
