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Person-centred medicine in the care home setting: development of a complex intervention. | LitMetric

AI Article Synopsis

  • - Person-centred medicine is essential for older patients in care homes, but their involvement in medication processes is often limited, prompting the need for a new intervention focused on enhancing participation and communication among residents, relatives, and healthcare professionals
  • - The intervention was developed in Aarhus, Denmark, following Medical Research Council guidelines and involved various methods like stakeholder engagement and workshops, incorporating patient input through the PREPAIR tool tailored for care homes
  • - After gathering feedback and testing with end-users, the intervention was refined to include a structured approach with two main components (the PREPAIR care home tool and a communication template) and an implementation strategy to effectively integrate it into routine care!

Article Abstract

Background: Person-centred medicine is recommended in the care of older patients. Yet, involvement of care home residents and relatives in medication processes remains limited in routine care. Therefore, we aimed to develop a complex intervention focusing on resident and relative involvement and interprofessional communication to support person-centred medicine in the care home setting.

Methods: The development took place from October 2021 to March 2022 in the Municipality of Aarhus, Denmark. The study followed the Medical Research Council guidance on complex intervention development using a combination of theoretical, evidence-based, and partnership approaches. The patient involvement tool, the PREparation of Patients for Active Involvement in medication Review (PREPAIR), was included in a preliminary intervention model. Study activities included developing programme theory, engaging stakeholders, and exploring key uncertainties through interviews, co-producing workshops, and testing with end-users to develop the intervention and an implementation strategy. The Consolidated Framework for Implementation Research and the Interprofessional Shared Decision Making Model were used. Data were analysed using a rapid analysis approach.

Results: Before the workshops, six residents and four relatives were interviewed. Based on their feedback, PREPAIR was modified to the PREPAIR care home to fit the care home population. In total, ten persons participated in the co-producing workshops, including health care professionals and municipal managerial and quality improvement staff. The developed intervention prototype was tested for three residents and subsequently refined to the final intervention, including two fixed components (PREPAIR care home and an interprofessional medication communication template) delivered in a flexible three-stage workflow. Additionally, a multi-component implementation strategy was formed. In line with the developed programme theory, the intervention supported health care professionals´ awareness about resident and relative involvement. It provided a structure for involvement, empowered the residents to speak, and brought new insights through dialogue, thereby supporting involvement in medication-related decisions. The final intervention was perceived to be relevant, acceptable, and feasible in the care home setting.

Conclusion: Our results indicate that the final intervention may be a viable approach to facilitate person-centred medicine through resident and relative involvement. This will be further explored in a planned feasibility study.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131350PMC
http://dx.doi.org/10.1186/s12875-024-02437-xDOI Listing

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