Family involvement in managing medications of older patients across transitions of care: A systematic review

Elizabeth Manias*, Tracey Bucknall, Carmel Hughes, Christine Jorm, Robyn Woodward-Kron

*Corresponding author for this work

Research output: Contribution to journalArticle

3 Citations (Scopus)
106 Downloads (Pure)

Abstract

Background: As older patients' health care needs become more complex, they often experience challenges with managing medications across transitions of care. Families play a major role in older patients' lives. To date, there has been no review of the role of families in older people's medication management at transitions of care. This systematic review aimed to examine family involvement in managing older patients' medications across transitions of care. Methods: Five databases were searched for quantitative, qualitative and mixed methods empirical studies involving families of patients aged 65 years and older: Cumulative Index to Nursing and Allied Health Literature Complete, Medline, the Cochrane Central Register of Controlled Trials, PsycINFO, and EMBASE. All authors participated independently in conducting data selection, extraction and quality assessment using the Mixed Methods Appraisal Tool. A descriptive synthesis and thematic analysis were undertaken of included papers. Results: Twenty-three papers were included, comprising 17 qualitative studies, 5 quantitative studies and one mixed methods study. Families participated in information giving and receiving, decision making, managing medication complexity, and supportive interventions in regard to managing medications for older patients across transitions of care. However, health professionals tended not to acknowledge the medication activities performed by families. While families actively engaged with older patients in strategies to ensure safe medication management, communication about medication plans of care across transitions tended to be haphazard and disorganised, and there was a lack of shared decision making between families and health professionals. In managing medication complexity across transitions of care, family members perceived a lack of tailoring of medication plans for patients' needs, and believed they had to display perseverance to have their views heard by health professionals. Conclusions: Greater efforts are needed by health professionals in strengthening involvement of families in medication management at transitions of care, through designated family meetings, clinical bedside handovers, ward rounds, and admission and discharge consultations. Future work is needed on evaluating targeted strategies relating to family members' contribution to managing medications at transitions of care, with outcomes directed on family understanding of medication changes and their input in preventing and identifying medication-related problems.

Original languageEnglish
Article number95
JournalBMC Geriatrics
Volume19
Issue number1
DOIs
Publication statusPublished - 29 Mar 2019

Keywords

  • Aged care facilities
  • Family
  • Family involvement
  • Home
  • Hospitals
  • Medication management
  • Older patients
  • Transitions of care

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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