| Autor: |
Fabricius PK; Department of Clinical Research, Copenhagen University Hospital-Amager and Hvidovre, 2650 Hvidovre, Denmark.; Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark., Aharaz A; Department of Clinical Research, Copenhagen University Hospital-Amager and Hvidovre, 2650 Hvidovre, Denmark.; The Capital Region Pharmacy, 2730 Herlev, Denmark., Stefánsdóttir NT; Department of Clinical Research, Copenhagen University Hospital-Amager and Hvidovre, 2650 Hvidovre, Denmark., Houlind MB; Department of Clinical Research, Copenhagen University Hospital-Amager and Hvidovre, 2650 Hvidovre, Denmark.; The Capital Region Pharmacy, 2730 Herlev, Denmark.; Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark., Steffensen KD; Center for Shared Decision Making, Lillebaelt University Hospital of Southern Denmark, 7100 Vejle, Denmark.; Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark., Andersen O; Department of Clinical Research, Copenhagen University Hospital-Amager and Hvidovre, 2650 Hvidovre, Denmark.; Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark.; Emergency Department, Copenhagen University Hospital-Amager and Hvidovre, 2650 Hvidovre, Denmark., Kirk JW; Department of Clinical Research, Copenhagen University Hospital-Amager and Hvidovre, 2650 Hvidovre, Denmark.; Department of Public Health, Nursing, Aarhus University, 8000 Aarhus, Denmark. |
| Abstrakt: |
Shared decision making (SDM) about medicine with older poly-medicated patients is vital to improving adherence and preventing medication-related hospital admissions, but it is difficult to achieve in practice. This study's primary aim was to provide insight into the extent of SDM in medication decisions in the Emergency Department (ED) and to compare how it aligns with older poly-medicated patients' preferences and needs. We applied a mixed-methods design to investigate SDM in medication decisions from two perspectives: (1) observational measurements with the observing patient involvement (OPTION 5) instrument of healthcare professionals' SDM behavior in medication decisions and (2) semi-structured interviews with older poly-medicated patients. A convergent parallel analysis was performed. Sixty-five observations and fourteen interviews revealed four overall themes: (1) a low degree of SDM about medication, (2) a variation in the pro-active and non-active patients approach to conversations about medicine, (3) no information on side effects, and (4) a preference for medication reduction. The lack of SDM with older patients in the ED may increase inequality in health. Patients with low health literacy are at risk of safety threats, nonadherence, and preventable re-admissions. Therefore, healthcare professionals should systematically investigate older poly-medicated patients' preferences and discuss the side effects and the possibility of reducing harmful medicine. |
