Abstract
Background
Globally, the population of older people is on the rise. As families are burdened with the high cost of care for aging members, demand is increasing for medical care and nursing homes. Thus, medication management is crucial to ensure that residents in a care center benefit and assist the management of the care center in reducing the burden of health care. This study is aimed to qualitatively explore issues related to medication management in residential aged care facilities (RACFs).
Participants and methods
A total of 11 stakeholders comprising health care providers, administrators, caretakers and residents were recruited from a list of registered government, nongovernmental organization and private RACFs in Malaysia from September 2016 to April 2017. An exploratory qualitative study adhering to Consolidated Criteria for Reporting Qualitative Studies was conducted. In-depth interview was conducted with consent of all participants, and the interviews were audio recorded for later verbatim transcription. Observational analysis was also conducted in a noninterfering manner.
Results and discussion
Three themes, namely medication use process, personnel handling medications and culture, emerged in this study. Medication use process highlighted an unclaimed liability for residents’ medication by the RACFs, whereas personnel handling medications were found to lack sufficient training in medication management. Culture of the organization did affect the medication safety and quality improvement. The empowerment of the residents in their medication management was limited. There were unclear roles and responsibility of who manages the medication in the nongovernment-funded RACFs, although they were well structured in the private nursing homes.
Conclusion
There are important issues related to medication management in RACFs which require a need to establish policy and guidelines.
Supplementary materials
Interview topic guide on issues faced regarding medication management in residential aged care facilities (RACFs)
Preamble: You have had experience in the practice of taking care of older persons in long-term care facilities. You would have planned, overseen, instructed others or administered medication to residents.
General questions: (set at 5, sequence and probing style). When question is posed and the participant answers, the researcher cues in and follows up the questioning process based from the emerging response.
For healthcare professional/healthcare provider
How long have you worked here/with residents? [NB: asking participants current situation before questions about the past or future aids engagement]
Tell me about your background?
What main concerns/issues do you face in your RACF?
Tell me how you manage medications at RACF?
Describe the process of giving medications to the resident?
What are the some of the problems you face when giving medication?
Are there any complications that arise when/after residents take their medications?
How do you perceive the importance of managing medication?
What would you like to see in terms of the managing of medications at your RACF in future?
For residents:
Thank you for meeting with me. Today I would like to talk to you about your medications you take.
How are you feeling today?
How is everything with your medicines?
How do you obtain your medications?
Do you take your own medications? (If not, then ask, who gives you your medication?)
Acknowledgments
This research was funded by Universiti Kebangsaan Malaysia (grant number FRGS/2/2014/SKKK02/UKM/03/1).
Disclosure
The authors report no conflicts of interest in this work.