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Title: Medicines management of older people in intermediate care facilities
Author: Millar, Anna
ISNI:       0000 0004 6058 9240
Awarding Body: Queen's University Belfast
Current Institution: Queen's University Belfast
Date of Award: 2016
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Intermediate care (IC) describes services which are targeted at older adults and aim to prevent unnecessary hospital admission, promote faster recovery from illness, support timely discharge and maximise independent living. The aim of the research presented in this thesis was to explore various aspects of medicines management relating to IC facilities, including how medicines are managed by staff and patients, communication between IC facilities and other healthcare settings, pharmacy involvement with IC, and the appropriateness of prescribing amongst the population that IC services cater for. Both qualitative and quantitative methodology was used throughout the five studies contained in this thesis. Various challenges relating to how medicines are prescribed, supplied and reviewed within IC were described. Despite an evident need, there was a distinct lack of pharmacy input within IC. Community pharmacists had limited awareness of and involvement with their local IC services and viewed communication relating to patients’ medications as inconsistent when patients moved across the various healthcare interfaces. Furthermore, cases of potentially inappropriate prescribing (PIP) were found in significant proportions of older patients at both admission to and discharge from IC. Similarly, PIP was found to be highly prevalent amongst older adults at discharge from secondary care, where deficits in the communication across the healthcare interface were also noted. The work contained in this thesis has highlighted various deficits in how medicines are managed in this patient population, both in the IC setting and beyond. Whilst there appears to be a mismatch between the concept of IC and the reality of services provided, appropriate management of medicines is a fundamental component of care for the patient population targeted by such services and requires further attention. Defining and evaluating how pharmacists can effectively integrate with IC services should form the focus of future work in this area.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available