Confirmed Medication Diversion in Hospice Care: Qualitative Findings From a National Sample of Agencies
Autor: | John G. Cagle, Mary Lynn McPherson, Paul Sacco, Jodi Jacobson Frey, Jack M. Guralnik, Orrin D. Ware |
---|---|
Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
03 medical and health sciences 0302 clinical medicine medicine Humans Medication monitoring Family 030212 general & internal medicine Prescribed medications General Nursing Hospice care business.industry Public health Qualitative descriptive Hospices Pain management Family member Anesthesiology and Pain Medicine Hospice Care Caregivers 030220 oncology & carcinogenesis Family medicine Good clinical practice Neurology (clinical) Drug Overdose business human activities |
Zdroj: | Journal of pain and symptom management. 61(4) |
ISSN: | 1873-6513 |
Popis: | Context The nonmedical use of prescribed medications is a major public health concern in the U.S. Medications prescribed to hospice patients for pain management may be at risk of being diverted to be sold or used illicitly. Objectives Use responses from hospice agency representatives to explore the details of confirmed cases of medication diversion in the hospice setting. Methods This is a qualitative descriptive study based on responses from hospice agency representatives with surveys completed by phone or online. Template analysis was used to describe the context of confirmed diversion, specifically 1) means of how the diversion was confirmed, 2) clues/red flags, 3) who diverted, and 4) agency responses to the confirmed diversion. Results A total of n = 112 open-ended responses were analyzed. Respondents reported multiple ways in which medication diversion was confirmed, such as drug screening, witnessed firsthand by staff, and an overdose. Clues/red flags included reluctance to allow medication monitoring, family discord, and higher medication doses being requested. Those who diverted medications included informal caregiver/family member, family friend, and facility staff. Agency responses to diversion included limiting the supply of medication, restricting access to the medication, and increasing staff visit frequency. Conclusion Good clinical practice and vigilance may help agencies detect medication diversion. Moreover, diversion prevention techniques should not harmfully impact quality of patient care. |
Databáze: | OpenAIRE |
Externí odkaz: |