Use this URL to cite or link to this record in EThOS: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.727647
Title: Medication use in people with advanced dementia approaching the end of life
Author: McCloskey, Bridgeen
ISNI:       0000 0004 6425 1589
Awarding Body: Queen's University Belfast
Current Institution: Queen's University Belfast
Date of Award: 2017
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Abstract:
Research evidence indicates that people with advanced dementia approaching the end of life continue to receive medications which have questionable benefits in advanced illness, however there are few available data to indicate the reasons for this. The overall aim of this thesis was to explore decision-making, approaches to care, prescribing and expectations in relation to medication use for people with advanced dementia approaching the end of life, from the perspectives of healthcare professionals and those involved in making decisions for the person with advanced dementia (carers, family members and relevant others). Qualitative and quantitative methodologies were used throughout the four studies described in this thesis. The first qualitative study employed face-to-face semi-structured interviews with physicians to explore how prescribing decisions were made for people with advanced dementia approaching the end of life. A mixed method study, using online questionnaires and semi-structured interviews, was conducted with pharmacists to explore their approaches to care for people with advanced dementia approaching the end of life. A cross-sectional study was undertaken to investigate medication use during the last seven days of life, in deceased older patients cared for in selected hospices and a hospital palliative care unit throughout Northern Ireland. Finally, a qualitative semi-structured interview study was used to explore Key Decision Makers’ expectations of prescribed medications for people with advanced dementia, and to elicit future expectations with respect to medications in light of changing goals of care and dementia progression. The findings in this thesis demonstrate that there is a multitude of factors that contribute to the prescription of medications for people with advanced dementia approaching the end of life. Further training, education and support for healthcare professionals are required and interdisciplinary collaboration should be encouraged to facilitate the optimal use of medicines in those with advanced dementia approaching the end of life.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.727647  DOI: Not available
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