Hospital inpatient self-administration of medicine programmes: a critical literature review

Wright, Julia L.; Emerson, Angela; Stephens, Martin; Lennan, Elaine

doi:10.1007/s11096-006-9014-x

Cited by 43 publications

(79 citation statements)

References 32 publications

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“…Models for this exist in the literature, even extending to patient medication selfadministration. [5][6][7] In our sample of inpatients, the majority desired a more active role in learning about their hospital medications and believed that their involvement might prevent hospital medication errors from occurring. Medication literacy, education, and active patient involvement in medication monitoring as a means to improve patient outcomes has received significant attention in the outpatient setting, with lessons applicable to the hospital.…”

Section: Discussionmentioning

confidence: 99%

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Lack of patient knowledge regarding hospital medications

Cumbler

Wald

Kutner

2009

Journal of Hospital Medicine

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BACKGROUND:Patient involvement in preventing inpatient medication errors is predicated upon patient knowledge of their medications. However, there is little published on the accuracy of patient knowledge or understanding of their hospital medications.OBJECTIVE:To assess hospitalized patients' knowledge of their hospital medications and attitudes towards involvement in the medication safety process while hospitalized.METHODS:A cross‐sectional study of 50 adult internal medicine inpatients at the University of Colorado Hospital. Patients completed a list of the hospital medications they believed were prescribed to them and a survey of attitudes toward involvement in the medication safety process. The patient‐completed hospital medication list was compared to the hospital medication administration record.RESULTS:Ninety‐six percent of study patients omitted at least one prescribed hospital medication. On average, patients omitted 6.8 hospital medications. Forty‐four percent of patients believed they were receiving at least one hospital medication that was not actually prescribed. Patients < 65 years old omitted 60% of their as needed (PRN) medications whereas patients ≥ 65 years old omitted 88% (P = 0.01). Only 28% reported having seen their hospital medication list, although 81% reported this would improve their satisfaction with hospital care. Ninety percent wanted to review their hospital medication list for accuracy and 94% felt patient review of the hospital medication list had the potential to reduce errors.CONCLUSIONS:Our findings suggest that, in contrast to patient preferences, there are significant deficits in patients' knowledge of hospital medications. These results are a call to reexamine how we educate patients regarding their hospital medications. Journal of Hospital Medicine 2010;5:83–86. © 2010 Society of Hospital Medicine.

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Section: Discussionmentioning

confidence: 99%

“…Such initiatives may result in increased patient participation and satisfaction. [4][5][6][7] There is also potential that increased patient knowledge of their hospital medications could promote the goal of medication safety, as the actively involved patient may be able to catch medication errors in the hospital.…”

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confidence: 99%

Lack of patient knowledge regarding hospital medications

Cumbler

Wald

Kutner

2009

Journal of Hospital Medicine

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“…Another approach to assessing a person’s capacity to manage their medicines accurately and safely is through a self-administration of medicines program (SAMP) [55]. These programs are offered in some hospitals, and enable a person to self-administer their medicines under supervision prior to discharge.…”

Section: Identifying Impaired Capacity To Manage Medicinesmentioning

confidence: 99%

“…difficulty opening containers, inability to remember to take their medicines) [56]. Inpatient SAMPs have also been reported to increase patients’ understanding of their medicines regimens and improve their ability to manage their medicines after discharge [55, 57]. …”

Section: Identifying Impaired Capacity To Manage Medicinesmentioning

confidence: 99%

Ability of older people with dementia or cognitive impairment to manage medicine regimens: a narrative review

Elliott¹,

Goeman²,

Beanland

et al. 2015

CCP

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Impaired cognition has a significant impact on a person’s ability to manage their medicines. The aim of this paper is to provide a narrative review of contemporary literature on medicines management by people with dementia or cognitive impairment living in the community, methods for assessing their capacity to safely manage medicines, and strategies for supporting independent medicines management. Studies and reviews addressing medicines management by people with dementia or cognitive impairment published between 2003 and 2013 were identified via searches of Medline and other databases. The literature indicates that as cognitive impairment progresses, the ability to plan, organise, and execute medicine management tasks is impaired, leading to increased risk of unintentional non-adherence, medication errors, preventable medication-related hospital admissions and dependence on family carers or community nursing services to assist with medicines management. Impaired functional capacity may not be detected by health professionals in routine clinical encounters. Assessment of patients’ (or carers’) ability to safely manage medicines is not undertaken routinely, and when it is there is variability in the methods used. Self-report and informant report may be helpful, but can be unreliable or prone to bias. Measures of cognitive function are useful, but may lack sensitivity and specificity. Direct observation, using a structured, standardised performance-based tool, may help to determine whether a person is able to manage their medicines and identify barriers to adherence such as inability to open medicine packaging. A range of strategies have been used to support independent medicines management in people with cognitive impairment, but there is little high-quality research underpinning these strategies. Further studies are needed to develop and evaluate approaches to facilitate safe medicines management by older people with cognitive impairment and their carers.

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“…Indeed, patients expressed their desire for such a program and administered their medications with proper documentation. It became clear to everyone that those who suffer a chronic illness must self-manage all the time, and they likely do this better than healthcare workers (17,18). This realization changed health professionals' role from that of absolute control of the medication delivery process to partnering with the patient to improve self-administration techniques rather than acting in a way that undermines patients' coping skills.…”

Section: Original Researchmentioning

confidence: 99%