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

Manias, Elizabeth, Bucknall, Tracey, Hughes, Carmel, Jorm, Christine and Woodward-Kron, Robyn 2019, Family involvement in managing medications of older patients across transitions of care: a systematic review, BMC geriatrics, vol. 19, no. 1, doi: 10.1186/s12877-019-1102-6.

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Title Family involvement in managing medications of older patients across transitions of care: a systematic review
Author(s) Manias, ElizabethORCID iD for Manias, Elizabeth
Bucknall, TraceyORCID iD for Bucknall, Tracey
Hughes, Carmel
Jorm, Christine
Woodward-Kron, Robyn
Journal name BMC geriatrics
Volume number 19
Issue number 1
Article ID 95
Total pages 21
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2019-03-29
ISSN 1471-2318
Keyword(s) Aged care facilities
Family involvement
Medication management
Older patients
Transitions of care
Science & Technology
Life Sciences & Biomedicine
Geriatrics & Gerontology
Summary 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.
Language eng
DOI 10.1186/s12877-019-1102-6
Field of Research 1103 Clinical Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2019, The Authors
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Document type: Journal Article
Collections: Faculty of Health
School of Nursing and Midwifery
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