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Making decisions about managing medications in hospital
chapterposted on 2008-12-01, 00:00 authored by Elizabeth ManiasElizabeth Manias
The purpose of this chapter is to examine the extent to which patients are involved in making decisions about their medications in hospital. Traditionally, decision-making about medications has involved patients taking a passive and receptive role without active participation. In contemporary health care, there is a focus on self care, shorter hospital stays, treatment of individuals with an increasing severity of illness, and positive benefits of patient involvement in improving health outcomes. Furthermore, patients have complex medication regimens that they are expected to manage when they are discharged home from hospital. It is therefore timely to consider how patients contribute to medication decisions. For this study, a descriptive prospective qualitative design was used, incorporating observations with health professionals and patients. Data collection was undertaken in a metropolitan university teaching hospital in Australia, using a stratified random sampling to recruit patients from 12 ward settings. This sampling method ensured that a broad cross-section of patients with different health problems was involved in the study. A medication decision making model was used as a framework to analyze the data according to four principles: identifying treatment goals, selecting different medication options, determining medication monitoring and evaluation, and identifying patient self care. Data findings demonstrated that patients continued to play a passive role in making decisions about their medications in hospital. On the other hand, there were instances where health professionals assisted patients to decide their own course of action about managing medications. In such situations patients were adequately prepared for their transition from hospital to home. This chapter examines the implications of findings for practice and health care policy. © 2007 Nova Science Publishers, Inc. All rights reserved.