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

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dc.contributor.authorMcGillicuddy, Aoife
dc.contributor.authorCrean, Abina M.
dc.contributor.authorKelly, Maria
dc.contributor.authorSahm, Laura J.
dc.contributor.funderScience Foundation Ireland
dc.contributor.funderIrish Research Council
dc.contributor.funderUniversity College Cork
dc.date.accessioned2018-02-20T13:24:11Z
dc.date.available2018-02-20T13:24:11Z
dc.date.issued2017
dc.description.abstractObjective: 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.sponsorshipIrish Research Council (GOIPG/2016/1634); University College Cork (Strategic Research Fund PhD Studentship)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleide018151
dc.identifier.citationMcGillicuddy, 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-2017-018151en
dc.identifier.doi10.1136/bmjopen-2017-018151
dc.identifier.endpage12
dc.identifier.issn2044-6055
dc.identifier.issued12
dc.identifier.journaltitleBMJ Openen
dc.identifier.startpage1
dc.identifier.urihttps://hdl.handle.net/10468/5495
dc.identifier.volume7
dc.language.isoenen
dc.publisherBMJ Publishing Groupen
dc.relation.projectinfo:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2275/IE/Synthesis and Solid State Pharmaceutical Centre (SSPC)/
dc.relation.urihttp://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-commercialen
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.subjectNursesen
dc.subjectMedicineen
dc.subjectTabletsen
dc.titleOral medicine modification for older adults: a qualitative study of nursesen
dc.typeArticle (peer-reviewed)en
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