PDF(Pubmed)
Abstract：
BACKGROUND: Dementia is a major global public health challenge, and with the growing elderly population, its prevalence is expected to increase in the coming years. In Sweden, municipalities are responsible for providing special housing for the elderly (SÄBO), which offers services and care for older individuals needing specific support. SÄBO is both the person´s home and a care environment and workplace. Polypharmacy in patients with dementia is common and increases the risk of medication interactions. Involving clinical pharmacists in medication reviews has been shown to enhance medication safety and improve prescribing practices. However, the views of the standard care team involved in medication prescribing, administration, monitoring and documentation on integrating pharmacist services have received less attention. Thus, this study aims to explore how pharmacists\' contributions can enhance medication safety, improve patient care efficiency, and potentially alleviate the workload of general practitioners for people with dementia living in special housing.
METHODS: This study has a descriptive qualitative study design using semi-structured interviews and qualitative content analysis. The study was conducted in a southern Swedish special housing and included nurses, assistant nurses, general practitioners (GPs), and a pharmacist. Due to the COVID-19 pandemic, interviews were conducted over the phone. The Swedish Ethical Review Authority approved the study.
RESULTS: The analysis revealed three main categories, and eleven subcategories.: (1) Integrating multidisciplinary approaches for holistic dementia care, (2) Strengthening dementia care through effective medication management and (3) Advancing dementia care through pharmacist integration and role expansion. Nurses focused on non-pharmacological treatments, while GPs emphasized the importance of medication reviews in assessing the benefits and side-effects of prescribed medication. Pharmacists were valued for their reliable medication expertise, appreciated by GPs for saving time and providing recommendations prior to consultations with individuals with dementia and their next-of-kin. Although medication reviews were considered beneficial, there was skepticism about their ability to solve all medication-related problems associated with dementia care.
CONCLUSIONS: This study highlights the critical role pharmacists play in enhancing medication safety and patient care efficiency in special housing for individuals with dementia. Despite the value of their contributions, communication barriers within healthcare teams pose significant challenges. Recognising potential pharmacist role expansion is essential to alleviate the workload of GPs and ensure effective collaborative practices for better patient outcomes.
METHODS: This study has a descriptive qualitative study design using semi-structured interviews and qualitative content analysis. The study was conducted in a southern Swedish special housing and included nurses, assistant nurses, general practitioners (GPs), and a pharmacist. Due to the COVID-19 pandemic, interviews were conducted over the phone. The Swedish Ethical Review Authority approved the study.
RESULTS: The analysis revealed three main categories, and eleven subcategories.: (1) Integrating multidisciplinary approaches for holistic dementia care, (2) Strengthening dementia care through effective medication management and (3) Advancing dementia care through pharmacist integration and role expansion. Nurses focused on non-pharmacological treatments, while GPs emphasized the importance of medication reviews in assessing the benefits and side-effects of prescribed medication. Pharmacists were valued for their reliable medication expertise, appreciated by GPs for saving time and providing recommendations prior to consultations with individuals with dementia and their next-of-kin. Although medication reviews were considered beneficial, there was skepticism about their ability to solve all medication-related problems associated with dementia care.
CONCLUSIONS: This study highlights the critical role pharmacists play in enhancing medication safety and patient care efficiency in special housing for individuals with dementia. Despite the value of their contributions, communication barriers within healthcare teams pose significant challenges. Recognising potential pharmacist role expansion is essential to alleviate the workload of GPs and ensure effective collaborative practices for better patient outcomes.
摘要：
背景：痴呆症是一项重大的全球公共卫生挑战，随着老年人口的增长，它的流行率预计将在未来几年增加。在瑞典,市政当局负责为老年人提供特殊住房（SäBO），为需要特定支持的老年人提供服务和护理。SäBO既是人的家，也是一个护理环境和工作场所。痴呆症患者的多药治疗很常见，并且会增加药物相互作用的风险。已证明，让临床药师参与药物审查可提高药物安全性并改善处方实践。然而,参与药物处方的标准护理团队的意见，administration,关于整合药剂师服务的监测和文件较少受到关注。因此，这项研究旨在探讨药剂师的贡献如何提高用药安全性，提高患者护理效率，并有可能减轻生活在特殊住房中的痴呆症患者的全科医生的工作量。
方法：本研究采用半结构化访谈和定性内容分析的描述性定性研究设计。这项研究是在瑞典南部的一个特殊住房中进行的，包括护士，助理护士,全科医生（GP），还有药剂师.由于COVID-19大流行，采访是通过电话进行的。瑞典伦理审查机构批准了这项研究。
结果：分析揭示了三个主要类别，和11个子类别。：(1)整合多学科方法进行整体痴呆症护理，（2）通过有效的药物管理加强痴呆护理；（3）通过药师整合和角色拓展推进痴呆护理。护士专注于非药物治疗，虽然全科医生强调药物审查在评估处方药的益处和副作用方面的重要性。药剂师因其可靠的药物专业知识而受到重视，全科医生感谢在与痴呆症患者及其近亲进行咨询之前节省时间并提供建议。虽然药物审查被认为是有益的，对于他们解决与痴呆治疗相关的所有药物相关问题的能力持怀疑态度.
结论：本研究强调了药师在提高痴呆症患者特殊住房的用药安全性和患者护理效率方面发挥的关键作用。尽管他们的贡献很有价值,医疗团队内部的沟通障碍构成了重大挑战。认识到潜在的药剂师角色扩展对于减轻全科医生的工作量并确保有效的协作实践以获得更好的患者结果至关重要。
方法：本研究采用半结构化访谈和定性内容分析的描述性定性研究设计。这项研究是在瑞典南部的一个特殊住房中进行的，包括护士，助理护士,全科医生（GP），还有药剂师.由于COVID-19大流行，采访是通过电话进行的。瑞典伦理审查机构批准了这项研究。
结果：分析揭示了三个主要类别，和11个子类别。：(1)整合多学科方法进行整体痴呆症护理，（2）通过有效的药物管理加强痴呆护理；（3）通过药师整合和角色拓展推进痴呆护理。护士专注于非药物治疗，虽然全科医生强调药物审查在评估处方药的益处和副作用方面的重要性。药剂师因其可靠的药物专业知识而受到重视，全科医生感谢在与痴呆症患者及其近亲进行咨询之前节省时间并提供建议。虽然药物审查被认为是有益的，对于他们解决与痴呆治疗相关的所有药物相关问题的能力持怀疑态度.
结论：本研究强调了药师在提高痴呆症患者特殊住房的用药安全性和患者护理效率方面发挥的关键作用。尽管他们的贡献很有价值,医疗团队内部的沟通障碍构成了重大挑战。认识到潜在的药剂师角色扩展对于减轻全科医生的工作量并确保有效的协作实践以获得更好的患者结果至关重要。
