Educating Homecare Nurses about Deprescribing of Medications to Manage Polypharmacy for Older Adults

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

The purpose of this study is to evaluate the acceptability, appropriateness, and effectiveness of educational intervention with homecare nurses about deprescribing of medications among older adults. An evaluation research study was conducted using survey design to evaluate deprescribing education with a total sample of 45 homecare nurses from three homecare organizations. Post-training evaluation data were evaluated using Likert scale and open-ended questions were analyzed using descriptive statistical analyses and qualitative thematic analysis. Post-intervention questionnaire responses provided descriptions about homecare nurses’ perspectives related to deprescribing education, as well as the effectiveness of training in addressing their knowledge gaps. The pilot-testing of deprescribing learning modules and educational training revealed acceptability and suitability for future scale-up to expand its future reach and adoption by other homecare organizations. This study provided important implications into the barriers that impact the effectiveness of deprescribing education, and facilitators that support the future refinement of learning modules.

Related collections

Most cited references 29

Record: found
Abstract: not found
Article: not found

Using thematic analysis in psychology

Virginia Braun, Victoria Clarke (2014)

0 comments Cited 18240 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study.

Karen Barnett, Stewart Mercer, Michael Norbury … (2012)

Long-term disorders are the main challenge facing health-care systems worldwide, but health systems are largely configured for individual diseases rather than multimorbidity. We examined the distribution of multimorbidity, and of comorbidity of physical and mental health disorders, in relation to age and socioeconomic deprivation. In a cross-sectional study we extracted data on 40 morbidities from a database of 1,751,841 people registered with 314 medical practices in Scotland as of March, 2007. We analysed the data according to the number of morbidities, disorder type (physical or mental), sex, age, and socioeconomic status. We defined multimorbidity as the presence of two or more disorders. 42·2% (95% CI 42·1-42·3) of all patients had one or more morbidities, and 23·2% (23·08-23·21) were multimorbid. Although the prevalence of multimorbidity increased substantially with age and was present in most people aged 65 years and older, the absolute number of people with multimorbidity was higher in those younger than 65 years (210,500 vs 194,996). Onset of multimorbidity occurred 10-15 years earlier in people living in the most deprived areas compared with the most affluent, with socioeconomic deprivation particularly associated with multimorbidity that included mental health disorders (prevalence of both physical and mental health disorder 11·0%, 95% CI 10·9-11·2% in most deprived area vs 5·9%, 5·8%-6·0% in least deprived). The presence of a mental health disorder increased as the number of physical morbidities increased (adjusted odds ratio 6·74, 95% CI 6·59-6·90 for five or more disorders vs 1·95, 1·93-1·98 for one disorder), and was much greater in more deprived than in less deprived people (2·28, 2·21-2·32 vs 1·08, 1·05-1·11). Our findings challenge the single-disease framework by which most health care, medical research, and medical education is configured. A complementary strategy is needed, supporting generalist clinicians to provide personalised, comprehensive continuity of care, especially in socioeconomically deprived areas. Scottish Government Chief Scientist Office. Copyright © 2012 Elsevier Ltd. All rights reserved.

0 comments Cited 1379 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

What is polypharmacy? A systematic review of definitions

Nashwa Masnoon, Sepehr Shakib, Lisa Kalisch-Ellett … (2017)

Background Multimorbidity and the associated use of multiple medicines (polypharmacy), is common in the older population. Despite this, there is no consensus definition for polypharmacy. A systematic review was conducted to identify and summarise polypharmacy definitions in existing literature. Methods The reporting of this systematic review conforms to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklist. MEDLINE (Ovid), EMBASE and Cochrane were systematically searched, as well as grey literature, to identify articles which defined the term polypharmacy (without any limits on the types of definitions) and were in English, published between 1st January 2000 and 30th May 2016. Definitions were categorised as i. numerical only (using the number of medications to define polypharmacy), ii. numerical with an associated duration of therapy or healthcare setting (such as during hospital stay) or iii. Descriptive (using a brief description to define polypharmacy). Results A total of 1156 articles were identified and 110 articles met the inclusion criteria. Articles not only defined polypharmacy but associated terms such as minor and major polypharmacy. As a result, a total of 138 definitions of polypharmacy and associated terms were obtained. There were 111 numerical only definitions (80.4% of all definitions), 15 numerical definitions which incorporated a duration of therapy or healthcare setting (10.9%) and 12 descriptive definitions (8.7%). The most commonly reported definition of polypharmacy was the numerical definition of five or more medications daily (n = 51, 46.4% of articles), with definitions ranging from two or more to 11 or more medicines. Only 6.4% of articles classified the distinction between appropriate and inappropriate polypharmacy, using descriptive definitions to make this distinction. Conclusions Polypharmacy definitions were variable. Numerical definitions of polypharmacy did not account for specific comorbidities present and make it difficult to assess safety and appropriateness of therapy in the clinical setting.

0 comments Cited 750 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): West J Nurs Res

Journal ID (iso-abbrev): West J Nurs Res

Journal ID (publisher-id): WJN

Journal ID (hwp): spwjn

Title: Western Journal of Nursing Research

Publisher: SAGE Publications (Sage CA: Los Angeles, CA )

ISSN (Print): 0193-9459

ISSN (Electronic): 1552-8456

Publication date (Electronic): 12 January 2021

Publication date (Print): November 2021

Volume: 43

Issue: 11

Pages: 1034-1042

Affiliations

[1 ]Ontario Tech University, Oshawa, ON, Canada

[2 ]Université de Montréal, Montréal, QC, Canada

[3 ]ParaMed Home Health Care (Past), ON, Canada

Author notes

[*]Winnie Sun, Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North Oshawa, Ontario L1H 7K4, Canada. Email: winnie.sun@ 123456ontariotechu.ca

Author information

Winnie Sun https://orcid.org/0000-0001-7616-5344

Article

Publisher ID: 10.1177_0193945920982599

DOI: 10.1177/0193945920982599

PMC ID: 8495304

PubMed ID: 33435859

SO-VID: b3e65a01-2b32-4ba5-b614-7c31b775ae4a

License:

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

History

Funding

Funded by: Social Sciences and Humanities Research Council of Canada, FundRef https://doi.org/10.13039/501100000155;

Award ID: 211005

Custom metadata

typesetter ts1

Keywords: deprescribing,education,homecare nurses,community health,geriatrics,polypharmacy,medication management

Data availability:

Keywords: deprescribing, education, homecare nurses, community health, geriatrics, polypharmacy, medication management

Educating Homecare Nurses about Deprescribing of Medications to Manage Polypharmacy for Older Adults

Read this article at

Abstract

Related collections

Sociology of education: objects and perspectives

Most cited references 29

Using thematic analysis in psychology

Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study.

What is polypharmacy? A systematic review of definitions

Author and article information

Journal

Affiliations

Author notes

Author information

Article

History

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 748

Cited by 2

Most referenced authors 611