Safer transitions of care: Enhancing older adults' and families' engagement with medicines management

Background: Enhancing older adults’ (≥ 65 years) and their families’ engagement with medicines management is key to improving patient safety across transitions of care. However, the nature and extent to which they are currently involved remains unclear and effective strategies to support engagement are still lacking.
Aim/Objective(s): To explore how older patients and their families are involved with medicines management across transitions of care and to identify possible approaches to improve engagement.
Methods: We conducted semi-structured interviews with older patients, their families, and health professionals on medical, surgical, geriatric and rehabilitation wards at four different hospital sites of a major metropolitan health service. Recordings were transcribed verbatim and analysed using inductive content analysis, which involved coding, categorisation, and thematic mapping.
Results: A total of 66 patients, 67 family members and 69 health professionals participated in the interviews. Three themes were conceptualised from the data: involvement in discussions about medicines management, factors influencing involvement and approaches enhancing engagement. Older patients’ and their families’ willingness to be more actively involved with managing medicines across transitions of care varied considerably. Although many were open to greater involvement, factors such as language barriers, time constraints during ward rounds and limited health literacy impacted on their ability to participate leading to a high level of trust in health professionals. Approaches suggested to enhance engagement were centred around improving communication and providing better educational support to both patients and their families.
Discussion: More targeted strategies are needed within hospitals to support older patients and their families with managing medicines as they move across transitions of care. These strategies should be tailored to reflect each individual’s preferred level of engagement. The approaches identified in this study provide a foundation for future research to design interventions aimed at enhancing support with medicines management across transitions of care.