부산대학교 도서관

Background/Purpose: Older adults self-manage their medications after hospital discharge, which can include high-alert drugs associated with Adverse Drug Events (ADEs). Studies indicate post-hospital ADEs are the most frequent adverse event and more than half of them occurred within the first two weeks. Few, if any, studies have described older adults' cognitive and psychomotor abilities to manage their medications after being discharged home. Home healthcare nurses work with older adults to promote self-management of medications. The study purpose was to test the feasibility of a Show Back Checklist to screen for problems older adults may have managing medications after discharge from a hospital or nursing home facility. Methods: The research team and a homecare nurse advisory panel created a Show Back Checklist to measure patients' proficiencies with five domains of medication management (i.e., identification; explanation, organization, administration and timing). Patients were recruited and enrolled if they were (a) aged 65 years or older; (b) English-speaking; (c) available for a home visit within one week of discharge from hospital or nursing facility; and (d) prescribed at least one high alert medication -antidiabetic, anticoagulant, or opioid. A physician and home-care nurse observed and documented patients' proficiency managing medications. Results: Twenty-two older adults participated. We found an average of 8 (SD ± 1.91) medications and 2 high-alert medications (SD ± 1.26) per participant. The most common high-alert medications were opioids (63.6%) then antidiabetics (54.5%) followed by anticoagulants (36.3%). Medication proficiency scores ranged from 20.3-100 with an average of 77.19 (SD ± 22.92). Of the five domains, patients demonstrated the lowest proficiency with organizing their medications (40.48 SD ± 38.67). Conclusions/Implications: Medication management is a complex task. The Show Back Checklist shows promise to identify domain-specific problems faced by older adults' managing their medications at home. [ABSTRACT FROM AUTHOR]