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Merenda T, Denis J, Patris S. Pharmaceutical care for visually impaired patients: a qualitative study of community pharmacists' needs and professional experience. Int J Clin Pharm 2024; 46:665-674. [PMID: 38407693 DOI: 10.1007/s11096-023-01684-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/30/2023] [Indexed: 02/27/2024]
Abstract
BACKGROUND Visual impairment is a disability that can have a significant impact on the ability to take medication safely. As a result, pharmacists must adjust their practice to provide targeted and adapted support for this type of patient. AIM The aims of the present study were (1) to illustrate the usual clinical practice of community pharmacists to support the optimisation of medication use in visually impaired patients, and (2) to identify solutions to improve pharmaceutical care for visually impaired patients. METHOD Semi-structured interviews with 18 French-speaking community pharmacists were conducted via videoconference in Belgium. Participants were recruited on a voluntary basis and through a snowball method. An interview guide was developed based on literature review. Interviews were carried out until theoretical saturation of the data, recorded, transcribed verbatim and analysed using thematic analysis. Data were organised by NVivo Software. RESULTS Four themes were identified: community pharmacists' training, identification of visually impaired patients by the pharmacist, communication with visually impaired patients and their proxies, and provision of appropriate pharmaceutical care. Participants stated that they had not received any training regarding visual impairment. They described that they did not always know how to recognise visually impaired patients and that communication was often difficult. CONCLUSION This qualitative study has highlighted a lack of knowledge and skills among community pharmacists regarding visual impairment. One possible solution could be to develop recommendations and tools to improve the care of these patients.
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Affiliation(s)
- Théodora Merenda
- Unit of Clinical Pharmacy, Faculty of Medicine and Pharmacy, University of Mons, Avenue du Champ de Mars 25, Building 6, 7000, Mons, Belgium.
| | - Jennifer Denis
- Unit of Clinical Psychology, Faculty of Psychology and Education, University of Mons, Place du Parc 14, 7000, Mons, Belgium
| | - Stéphanie Patris
- Unit of Clinical Pharmacy, Faculty of Medicine and Pharmacy, University of Mons, Avenue du Champ de Mars 25, Building 6, 7000, Mons, Belgium
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Ibrahim NA, Wong YY, Lean QY, Ramasamy K, Lim SM, Tan MP, Abdul Majeed AB. Medication self-management among older adults with cognitive frailty. Res Social Adm Pharm 2024; 20:172-181. [PMID: 37980238 DOI: 10.1016/j.sapharm.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/02/2023] [Accepted: 11/02/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Independent and safe medication self-management is essential for successful aging. Nevertheless, how older adults with cognitive frailty (CF) self-manage medications at their own homes remain elusive. OBJECTIVE This study aimed at assessing the medication self-management capability of home-dwelling older adults with CF and exploring the ways, perceived challenges and barriers in medication self-management. METHODS A convergent mixed-method study design was used. The medication management capability of 16 CF individuals aged ≥ 60 years on ≥ 1 long-term prescription drugs were assessed using the Drug Regimen Unassisted Grading Scale (DRUGS). Virtual in-depth interviews were also performed between July-August 2022 using a semi-structured interview guide. All interviews were audio-recorded and transcribed verbatim. Qualitative data were analysed using a thematic analysis approach guided by Bailey and colleagues' model of medication self-management. RESULTS The mean DRUGS summary score was 96.86 [standard deviation (SD) 3.74] with highest performance scores observed in medication access (100 %) and lowest performance score in medication identification (91.46 %). Informants were able to independently take their medications and they tended to organise their medication intakes according to mealtime even though some admitted missing medication doses due to forgetfulness. Informants had difficulties with recalling drug names, with little awareness of self-monitoring their own health conditions and the effects of medications. Misconceptions towards medications, difficulties in accessing medications, reduced mobility and worsening health conditions could potentially deter informants from safe and independent medication self-management. In contrast, trust in doctors and a desire to achieve treatment goal could motivate medication self-management. CONCLUSION The findings revealed knowledge gaps among older adults with CF in identifying their medications and self-monitoring which warrant reinforcement by healthcare professionals to ensure chronic safe medication use. Future studies should evaluate strategies to enhance medication safety in terms of self-monitoring in individuals with CF.
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Affiliation(s)
- Nurul Alyaa Ibrahim
- Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Kampus Puncak Alam, 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia; Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Pulau Pinang, Bertam Campus, 13200 Kepala Batas, Pulau Pinang, Malaysia
| | - Yuet Yen Wong
- Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Pulau Pinang, Bertam Campus, 13200 Kepala Batas, Pulau Pinang, Malaysia; Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, University Teknologi MARA (UiTM) Cawangan Selangor, Kampus Puncak Alam, 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia.
| | - Qi Ying Lean
- Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Pulau Pinang, Bertam Campus, 13200 Kepala Batas, Pulau Pinang, Malaysia
| | - Kalavathy Ramasamy
- Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Kampus Puncak Alam, 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia; Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, University Teknologi MARA (UiTM) Cawangan Selangor, Kampus Puncak Alam, 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia
| | - Siong Meng Lim
- Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Kampus Puncak Alam, 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia; Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, University Teknologi MARA (UiTM) Cawangan Selangor, Kampus Puncak Alam, 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia
| | - Maw Pin Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Abu Bakar Abdul Majeed
- Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Kampus Puncak Alam, 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia; Brain Degeneration and Therapeutics Group, Faculty of Pharmacy, University Teknologi MARA (UiTM) Cawangan Selangor, Kampus Puncak Alam, 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia
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Fuzesi P, Broadfoot K, Lennon M, Jacob SA, Macaden L, Smith A, Welsh T, Watson MC. The Burden of Managing Medicines for Older People With Sensory Impairment: An Ethnographic-Informed Study. Gerontol Geriatr Med 2024; 10:23337214241253410. [PMID: 38765919 PMCID: PMC11100380 DOI: 10.1177/23337214241253410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 04/21/2024] [Accepted: 04/22/2024] [Indexed: 05/22/2024] Open
Abstract
Background: Older age is associated with increased prevalence of sensory impairment and use of medicines. Objectives: To explore the daily "medicine journey" of older people with sensory impairment. Methods: The study used ethnographic-informed methods (using audio-, photo- and video-recordings, diary notes and semi-structured interviews with researchers) and involved community-dwelling adults (aged > 65) in Scotland, with visual and/or hearing impairment and using >4 medicines. Data analysis used the constant comparative method. Results: Fourteen older people with sensory impairment participated and used a mean of 11.0 (SD 5.0) medicines (range 5-22). Participants reported difficulties with medicine ordering, obtaining, storage, administration and disposal. They used elaborate strategies to manage their medicines including bespoke storage systems, fixed routines, simple aids, communication, and assistive technologies. Conclusion: Older people with sensory impairment experience substantial burden, challenges and risk with medicines management. Tailored medicine regimens and assistive technologies could provide greater support to older people with sensory impairment.
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Affiliation(s)
- Peter Fuzesi
- University of Strathclyde, Glasgow, Scotland, UK
| | | | | | - Sabrina Anne Jacob
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Glasgow, Scotland, UK
| | | | - Annetta Smith
- University of the Highlands and Islands, Inverness, Scotland, UK
| | - Tomas Welsh
- Research Institute for the Care of Older People, Bath, UK
- Royal United Hospitals Bath, UK
- University of Bristol, UK
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Cooper L, Fuzesi P, Jacob SA, Kamalakannan S, Lennon M, Macaden L, Smith A, Welsh T, Broadfoot K, Watson MC. Assistive technologies and strategies to support the medication management of individuals with hearing and/or visual impairment: A scoping review. Disabil Health J 2023; 16:101500. [PMID: 37481354 DOI: 10.1016/j.dhjo.2023.101500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 06/11/2023] [Accepted: 06/16/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Individuals with sensory impairment (visual and/or hearing) experience health inequalities and increased the risk of medication-related iatrogenic disease compared with the general population. Assistive technologies and tailored strategies could support medication management for individuals with sensory impairment to reduce harm and increase the likelihood of therapeutic benefit. OBJECTIVE This scoping review identified assistive technologies and strategies to support medication management of/for people with hearing and/or visual impairment. METHODS Standard scoping review methodology was used to identify studies that evaluated technologies or strategies designed to support people with sensory impairment with independent medicine management. Electronic databases were searched (MEDLINE, Embase, CINAHL, ACM, Cochrane) from inception to 18/07/22. Independent duplicate screening, selection, and data extraction were undertaken. RESULTS Of 1231 publications identified, 18 were included, reporting 17 studies, 16 of which evaluated technologies to assist people with visual impairment and one study to assist people with hearing impairment. The range of technologies and devices included: applications for android phones (n = 6); eyedrop-assistance devices (n = 5); audio-prescription labelling/reading systems (n = 2); touch-to-speech devices (n = 2); continuous glucose monitoring system (n = 1); magnifying technology (n = 1). Ten studies tested early-stage prototypes. Most participants could operate the technologies effectively and deemed them to be useful. CONCLUSIONS Despite the increasing number of medicine-related assistive technologies, there has been limited empirical evaluation of their effectiveness for supporting individuals with sensory impairment. Prototypes appear to be useful for people with visual or hearing impairment, however wider 'real-life' testing is needed to confirm the benefits of these technologies.
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Affiliation(s)
- Lesley Cooper
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, UK
| | - Peter Fuzesi
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, UK
| | - Sabrina Anne Jacob
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, UK
| | - Sureshkumar Kamalakannan
- Department of Social Work, Education and Community Well-being, Northumbria University, Sutherland Building, 2 Ellison Pl, Newcastle Upon Tyne NE1 8ST, UK.
| | - Marilyn Lennon
- Department of Computer and Information Science, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, UK.
| | - Leah Macaden
- Nursing Studies, School of Health in Social Science, University of Edinburgh, Old College, South Bridge, Edinburgh EH8 9YL, UK.
| | - Annetta Smith
- University of the Highlands and Islands, 12b Ness Walk, Inverness IV3 5SQ, UK.
| | - Tomas Welsh
- RICE, The Research Institute for the Care of Older People, 8, The RICE Centre Royal United Hospital, Combe Park, Bath BA1 3NG, UK.
| | - Kirsten Broadfoot
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, UK.
| | - Margaret C Watson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, UK.
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Henshaw H, Calvert S, Heffernan E, Broome EE, Burgon C, Dening T, Fackrell K. New horizons in hearing conditions. Age Ageing 2023; 52:afad150. [PMID: 37604677 PMCID: PMC10442518 DOI: 10.1093/ageing/afad150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Indexed: 08/23/2023] Open
Abstract
Hearing conditions such as hearing loss, tinnitus and hyperacusis are highly prevalent in the population and can severely impact communication and quality of life. Hearing is affected by multiple factors, including heredity, noise exposure, age, sex, ear disorders and lifestyle factors. Globally, hearing loss affects over 80% of adults aged 80 years and older, is often experienced in combination with other long-term health conditions and is a mid-life risk factor for dementia. To form a themed collection, we searched Age and Ageing for articles on hearing conditions published from 2000 onwards. This resulted in 22 articles included within the collection. They examined a range of important topics related to hearing healthcare and research, including noise-induced hearing loss, health service quality and safety, psychological and psychosocial consequences of hearing loss and co-morbidities of hearing loss. All articles reported on hearing loss; there were no published articles with a primary focus on other hearing conditions such as tinnitus or hyperacusis, on the health of older people from the Deaf community or on users of Cochlear implants, suggesting key gaps in knowledge and targets for future research. This New Horizons article highlights novel directions in research and practice and takes a forward look at how research into hearing conditions may develop in years to come. It highlights opportunities for the growth of patient-centred research and hearing healthcare supported by the better integration of health and care services as well as cross-speciality working to include common co-morbid health conditions.
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Affiliation(s)
- Helen Henshaw
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
| | - Sian Calvert
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
| | - Eithne Heffernan
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
| | - Emma E Broome
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
| | - Clare Burgon
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
| | - Tom Dening
- Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
| | - Kathryn Fackrell
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
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Cheng C, Yu H, Wang Q. Nurses' Experiences Concerning Older Adults with Polypharmacy: A Meta-Synthesis of Qualitative Findings. Healthcare (Basel) 2023; 11:healthcare11030334. [PMID: 36766909 PMCID: PMC9914425 DOI: 10.3390/healthcare11030334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/26/2023] Open
Abstract
Polypharmacy is an increasing health concern among older adults and results in many health risks. Nurses have an important role to play in supporting medication management and promoting medication safety across different settings. This study aims to provide a meta-synthesis of qualitative studies investigating the perceptions and experiences of nurses in caring for older adults with polypharmacy. Electronic databases including PsycArticles, CINAHL Complete, MEDLINE, and ERIC were searched between September 2001 and July 2022. Potential studies were checked against inclusion and exclusion criteria. We included peer-reviewed studies reporting data on the experiences of nursing staff across different settings. Studies unitizing any qualitative approach were included, and the included studies were reviewed and analyzed using a thematic synthesis approach. Study quality was examined using the Critical Appraisal Skills Programme checklist for qualitative research. A total of nine studies with 91 nurses were included. Four major themes emerged: older adults suffering from polypharmacy, the importance of multidisciplinary teams, nursing roles in caring for older adults, and the complexity and barriers of implementing polypharmacy management. Healthcare professionals should pay attention to the impacts of polypharmacy in older adults' lives and should acknowledge the importance of team-based polypharmacy care in supporting older adults. Nurses play a key role in caring for older adults with polypharmacy, therefore, they should be empowered and be involved in medication management.
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Affiliation(s)
- Cheng Cheng
- School of Nursing, Fudan University, Shanghai 200032, China
- Correspondence: ; Tel.: +86-21-64431003
| | - Huan Yu
- School of Nursing, Anhui Medical University, Hefei 230032, China
| | - Qingling Wang
- School of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
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Jaiswal A, Gupta S, Paramasivam A, Santhakumaran S, Holzhey P, Dupont P, Wittich W. Continuum of Care for Older Adults With Concurrent Hearing and Vision Impairment: A Systematic Review. Innov Aging 2022; 7:igac076. [PMID: 36852347 PMCID: PMC9960032 DOI: 10.1093/geroni/igac076] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Indexed: 12/23/2022] Open
Abstract
Background and Objectives A global report estimates up to 2% of the world population experience concurrent hearing and vision impairment (dual sensory impairment [DSI]). Older adults with DSI are often frequent users of health care, yet the evidence is limited to inform care delivery for this population. This systematic review aimed to synthesize evidence on tools and strategies for screening, assessment, and interventions that promote a continuum of care for older adults with DSI. Research Design and Methods The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews. Electronic databases (CINAHL, Embase, MEDLINE, PsycINFO, Cochrane Library, Global Health, and Web of Science) and clinical trial registries (ISRCTN Registry, WHO ICTRP, and ClinicalTrials.gov) were searched. The quality appraisal was performed using the Mixed Methods Appraisal Tool. Results Of 4,775 identified references, 28 records were selected. The review identified 7 tools and 7 strategies for DSI-specific screening, assessments, and/or interventions. Some of the most promising tools were the interRAI Community Health Assessment with deafblind supplement, adapted Montreal Cognitive Assessment, and the Severe Dual Sensory Loss screening tool. Useful strategies included the use of alternative forms of communication, assistive devices or technology, education and training for service providers, and training of older adults on the use and maintenance of assistive aids/technology. However, quality appraisal indicated a need for more robust evidence to inform clinical practice. Discussion and Implications Reviewed evidence pinpointed the need for training for health care providers on DSI-specific challenges and supports and the use of integrated multidisciplinary care for older adults. Future studies need to explore the development and evaluation of tools and interventions to improve the continuum of care for this group. Systematic Review Registration: PROSPERO registration # CRD42020180545.
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Affiliation(s)
- Atul Jaiswal
- Address correspondence to: Atul Jaiswal, PhD, MSW, BOT, School of Optometry, University of Montreal, 3744, rue Jean-Brillant, Bureau 6442, Montréal, QC H3T 1P1, Canada. E-mail:
| | - Shikha Gupta
- School of Optometry, Université de Montréal, Montreal, Quebec, Canada
| | | | | | - Peter Holzhey
- School of Optometry, Université de Montréal, Montreal, Quebec, Canada
| | - Patrice Dupont
- School of Optometry, Université de Montréal, Montreal, Quebec, Canada
| | - Walter Wittich
- School of Optometry, Université de Montréal, Montreal, Quebec, Canada,CRIR/Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, Quebec, Canada
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