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‘It's a job to be done’. Managing polypharmacy at home: A qualitative interview study exploring the experiences of older people living with frailty
Previdoli, Giorgia Alldred, David P. Tyndale-Biscoe, S. Okeowo, D. Cheong, V.
Previdoli, Giorgia
Alldred, David P.
Tyndale-Biscoe, S.
Okeowo, D.
Cheong, V.
Publication Date
2024-02
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© 2024 The Authors. Health Expectations published by John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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openAccess
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2023-12-14
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Abstract
Introduction: Many older people live with both multiple long‐term conditions and
frailty; thus, they manage complex medicines regimens and are at heightened risk of
the consequences of medicines errors. Research to enhance how people manage
medicines has focused on adherence to regimens rather than on the wider skills
necessary to safely manage medicines, and the older population living with frailty
and managing multiple medicines at home has been under‐explored. This study,
therefore, examines in depth how older people with mild to moderate frailty manage
their polypharmacy regimens at home.
Methods: Between June 2021 and February 2022, 32 patients aged 65 years or
older with mild or moderate frailty and taking five or more medicines were recruited
from 10 medical practices in the North of England, United Kingdom, and the CARE
75+ research cohort. Semi‐structured interviews were conducted face to face, by
telephone or online. The interviews were recorded, transcribed verbatim and
analysed using reflexive thematic analysis.
Findings: Five themes were developed: (1) Managing many medicines is a skilled job I
didn't apply for; (2) Medicines keep me going, but what happened to my life?; (3)
Managing medicines in an unclear system; (4) Support with medicines that makes my
work easier; and (5) My medicines are familiar to me—there is nothing else I need (or
want) to know.
While navigating fragmented care, patients were expected to fit new medicines
routines into their lives and keep on top of their medicines supply. Sometimes, they felt let down by a system that created new obstacles instead of supporting their
complex daily work.
Conclusion: Frail older patients, who are at heightened risk of the impact of
medicines errors, are expected to perform complex work to safely self‐manage
multiple medicines at home. Such a workload needs to be acknowledged, and more
needs to be done to prepare people in order to avoid harm from medicines.
Patient and Public Involvement: An older person managing multiple medicines at
home was a core member of the research team. An advisory group of older patients
and family members advised the study and was involved in the first stages of data
analysis. This influenced how data were coded and themes shaped.
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Published version
Citation
Previdoli G, Alldred DP, Silcock J et al (2024) ‘It's a job to be done’. Managing polypharmacy at home: A qualitative interview study exploring the experiences of older people living with frailty. Health Expectations. 27(1): e13952.
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