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ACTIONS FOR POLICY AND IMPLEMENTATION

All health professionals, including doctors, nurses and pharmacists, should communicate with older patients about their medications from admission to discharge. Older patients should have the opportunity to ask questions and make decisions.

Health professionals need to communicate about medications by taking account of older patients’ beliefs, understandings, and goals of care.

Dedicated time is needed to listen to older patients’ concerns, to ask questions to ensure understanding of medications, and to adopt a caring approach to communication about medications.

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AUTHORS

 Prof Elizabeth Manias, Dr Kathryn Joseph and PhD candidate Guncag Ozavci (Deakin University), Prof Tracey Bucknall (Deakin University / Alfred Health), Prof Robyn Woodward-Kron (University of Melbourne), Prof Carmel Hughes, Queen’s University Belfast, Adj Prof Christine Jorm (University of Sydney).

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RESEARCH CONTEXT

An examination was undertaken of research studies published on older patients’ views and experiences of how health professionals manage their medications as older patients moved from one care environment to another. In all, 33 studies were found, which used different methods to do the research.

Older patients wanted to know why they were prescribed new medications and why some doses changed. They sought explanations about the medications prescribed during their hospitalisation as they arrived and left different care settings, especially about medication changes. Knowing why and how medications should be taken were important in managing medications after discharge. Having the brand and generic names of medications explained was considered helpful. Older patients who received follow-up telephone calls and visits after discharge reported greater likelihood of taking their medications.

Older patients appreciated having a written summary about their medications given to them before they left a care setting. They wanted this information to be written in plain language, using large-size font, with clear explanations about why, when and how to take their medications. Visual information about the medications also helped. Older patients believed an easy-to-understand written summary assisted them to better manage their health.

Being very old, or from non-English speaking background affected their experiences of communication about medications. These individuals had problems remembering medication instructions and needed opportunities and time to work through these instructions. Interpreters who spoke their language were beneficial in helping older patients of non-English backgrounds to manage their medications. Older patients also needed time to ask questions when they had problems with their hearing or sight, or had slurred speech.

Older patients believed that medication advice from health professionals on hospital admission and just before discharge was useful in reducing wrong dosages, missed medications and incorrect prescriptions. This advice helped to improve knowledge and decision making among older patients and families. Improved medication knowledge among older patients was related to greater levels of satisfaction about their hospital stay, and reduced hospital admissions to hospital.

Older patients were unhappy if health professionals did not listen to their concerns before discharge, and if health professionals made decisions without checking what the general practitioner had prescribed before their hospital admission. Many families often felt they were not given the chance to ask questions or to be involved in medication decisions during older patients’ hospitalisation as they moved between settings, and medication changes were largely made without the families’ input.

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