Oral medicine modification for older adults: a qualitative study of nurses

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dc.contributor.author McGillicuddy, Aoife
dc.contributor.author Crean, Abina M.
dc.contributor.author Kelly, Maria
dc.contributor.author Sahm, Laura J.
dc.date.accessioned 2018-02-20T13:24:11Z
dc.date.available 2018-02-20T13:24:11Z
dc.date.issued 2017
dc.identifier.citation McGillicuddy, A., Crean, A. M., Kelly, M. and Sahm, L. (2017) 'Oral medicine modification for older adults: a qualitative study of nurses', BMJ Open, 7(12), e018151 (12pp). doi: 10.1136/bmjopen-2017-018151 en
dc.identifier.volume 7
dc.identifier.issued 12
dc.identifier.startpage 1
dc.identifier.endpage 12
dc.identifier.issn 2044-6055
dc.identifier.uri http://hdl.handle.net/10468/5495
dc.identifier.doi 10.1136/bmjopen-2017-018151
dc.description.abstract Objective: Oral medicines are frequently modified (eg, tablets crushed) for older adults. However, these modifications can have clinical, legal and/or ethical implications. Nurses bear responsibility for medicine administration and hence, perform these modifications. The aim of this study was to investigate the knowledge, attitudes and beliefs of nurses about oral medicine modification for older adults. Design: A qualitative study was conducted using semi-structured, face-to-face interviews with nurses providing care to older adults in acute and long-term care settings. Interviews were audio-recorded, transcribed verbatim and analysed thematically. Settings: Sixteen purposively selected care settings; 4 acute-care and 12 long-term care settings were included. Nurses were recruited by convenience sampling at these sites. Participants: Eighteen nurses participated (83% female, 67% long-term care, 33% acute-care, median age (IQR) 38 years (32.5–52.0)). Results: Three major themes: modifying—a necessary evil, nurses’ role as patient advocate and modifying—we are working very much as a team and two minor themes: fractional dosing, and covert administration emerged from the data. Nurses viewed oral medicine modifications as being a routine and necessary occurrence in geriatric patient care due to limitations of available formulations and the presence of age-related challenges in drug administration. Nurses’ knowledge of residents’ requirements ensured that they advocate for those with individualised formulation needs, however, nurses rely on pharmacists for information about modifications. Nurses expressed a desire for supports including increased education and ward-specific, pharmacist-developed recommendations on common modifications. Conclusions: This study has provided useful insights into the views of nurses regarding oral medicine modification for older adults. The unique and varied formulation requirements of older adults must be acknowledged. Increased engagement by healthcare professionals, the pharmaceutical industry, regulatory agencies and policy-makers is required to facilitate the development of age-appropriate formulations. In the interim, practical interventions, informed by the findings of this study, are required. en
dc.description.sponsorship Irish Research Council (GOIPG/2016/1634); University College Cork (Strategic Research Fund PhD Studentship) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher BMJ Publishing Group en
dc.relation.uri http://bmjopen.bmj.com/content/7/12/e018151
dc.rights © 2017, the Authors. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial en
dc.rights.uri https://creativecommons.org/licenses/by-nc/4.0/
dc.subject Nurses en
dc.subject Medicine en
dc.subject Tablets en
dc.title Oral medicine modification for older adults: a qualitative study of nurses en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Aoife McGillicuddy, Pharmacy, University College Cork, Cork, Ireland. +353-21-490-3000 Email: a.mcgillicuddy@umail.ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Science Foundation Ireland
dc.contributor.funder Irish Research Council
dc.contributor.funder University College Cork
dc.description.status Peer reviewed en
dc.identifier.journaltitle BMJ Open en
dc.internal.IRISemailaddress a.mcgillicuddy@umail.ucc.ie en
dc.internal.IRISemailaddress l.sahm@ucc.ie en
dc.identifier.articleid e018151
dc.relation.project info:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2275/IE/Synthesis and Solid State Pharmaceutical Centre (SSPC)/


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© 2017, the Authors. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial Except where otherwise noted, this item's license is described as © 2017, the Authors. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial
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