A framework to improve medication management with older people
Research type
Research Study
Full title
Developing a framework for a novel multi-disciplinary, multi-agency intervention(s), to improve medication management in older people on complex medication regimens resident in the community (MEMORABLE)
IRAS ID
211031
Contact name
Ian D Maidment
Contact email
Sponsor organisation
AHRIC (Aston Health Research and Innovation Cluster)
Clinicaltrials.gov Identifier
17/EE/0357, A framework to improve medication management with older people
Duration of Study in the UK
1 years, 7 months, 31 days
Research summary
Summary of Research
Long term conditions are more common in older people. More older people are living with more of these conditions. Complex treatment regimes for these conditions can increase the risks associated with medication.
Some older people manage this on their own but some may struggle and need help from family, friends or formal carers. Doctors, nurses and pharmacists can all support older people with their medication but this needs to be coordinated.
The consequences of medication-related adverse events are stark. In the UK every year, these are estimated to cause 5,700 deaths, 5 to 8% of unplanned hospital admissions and costs the NHS £750 million (.
Improving medication management for and with older people with multiple long-term conditions will reduce avoidable harm and improve quality of life.
Aim
To develop a framework ('interventions') to support older people living in the community and their carers to manage their medication more safely and effectively.
Methods
1. Literature Review
This research will use a particular method of literature review (‘realist synthesis’) that is ideally suited for making sense of complex processes. Documents containing information on supporting older people in the community to manage their medication will be analysed to identify ‘what works for whom, in what circumstances, how and why?’.2. Interviews / focus group
These will build on and expand the literature review. Older people, carers and practitioners will be asked what helps them to manage their medication or to support others with this. If they identify new issues, these will be followed up by a further review of the literature in those areas.3. Developing a framework
Finally, information from the review and interviews will be combined to develop a proposed approach to support older people living in the community to manage their medication more safely and effectively.Summary of Result
Why we did this study:
Older people are taking more tablets. Medication can be difficult to manage. Not everyone takes their tablets as recommended, putting them at risk and leading to waste. Helping with medication can be a big responsibility for family or friends. There are time and money pressures on practitioners.
Medication management is an increasingly important issue.What we have done:
MEMORABLE looked at what has been written about medication management. We listened to older people and family carers about the way they manage their medication. Doctors, nurses, pharmacists and paid carers have told us about their experiences. Everyone has made suggestions about would make medication management better and easier.What we found out:
We now understand that medication management has different stages, such as starting new tablets or going to reviews with a doctor, nurse or pharmacist. What is done in each stage should help fit medication into older people’s lives. Shared decisions about routines and goals help older people feel in control and cope.
When older people find medication a burden, they may not tell anyone. We suggest that health and care staff need a simple way, a couple of questions, to find out who is not coping and needs more help, advice or support.
We also understand that older people and family carers get a lot of information from health and care staff. Information may not seem relevant when it is only about one of their health problems or medications. It may be difficult to remember. We suggest that older people should have their own information, about them and all their illnesses and medications, put together in a way that they can use and share with others if they want to. This individual information would help them to manage their medication as part of their day-to-day lives.REC name
East of England - Cambridgeshire and Hertfordshire Research Ethics Committee
REC reference
17/EE/0357
Date of REC Opinion
25 Sep 2017
REC opinion
Further Information Favourable Opinion