Abstract
Background: Polypharmacy and potentially inappropriate medications are significant challenges in older adults’ medication management. The Consolidated Framework for Implementation Research (CFIR) is a comprehensive approach used to explore barriers and enablers to the healthcare system in guiding the effective implementation of evidence-based practices.
Objectives: This study examines the barriers and enablers to promote safe medication management among older adults in Qatar from healthcare professionals’ perspectives. This includes identifying critical factors within the healthcare system influencing medication management and suggesting practical solutions to improve it.
Design: The study employs a qualitative design. Focus Groups (FGs) were conducted with healthcare professionals from the geriatric, mental health and medicine departments of Hamad Medical Corporation (HMC), the leading governmental sector in Qatar serving the older adult population.
Methods: Utilising the CFIR, this study analysed feedback from healthcare professionals through FGs at HMC. A combined inductive and deductive thematic analysis was applied to transcripts from five FGs, focusing on identifying barriers and enablers to safe medication management among older adults. Two researchers transcribed the audio-recorded FG discussions verbatim, and two researchers analysed the data using a mixed inductive and deductive thematic analysis approach utilising CFIR constructs.
Results: We engaged 53 healthcare professionals (31 physicians, 10 nurses and 12 clinical pharmacists) in FGs. The analysis identified current barriers and enabler themes under different CFIR constructs, including inner settings, outer settings, individual characteristics and intervention characteristics. We identified 44 themes, with 25 classifieds as barriers and
19 as enablers. The findings revealed that barriers and enablers within the inner settings were primarily related to structural characteristics, resources, policies, communication and culture. On the other hand, barriers and enablers from the outer settings included patients and caregivers, care coordination, policies and laws, and resources.
Conclusion: This study identified several barriers and enablers to promote medication management for older adults using the CFIR constructs from the perspective of healthcare professionals. The multifaceted findings emphasise involving stakeholders like clinical leaders, policymakers and decision-makers to address medication safety factors. A robust action plan, continuously monitored under Qatar’s national strategy, is vital. Further research is needed to implement recommended interventions.
Objectives: This study examines the barriers and enablers to promote safe medication management among older adults in Qatar from healthcare professionals’ perspectives. This includes identifying critical factors within the healthcare system influencing medication management and suggesting practical solutions to improve it.
Design: The study employs a qualitative design. Focus Groups (FGs) were conducted with healthcare professionals from the geriatric, mental health and medicine departments of Hamad Medical Corporation (HMC), the leading governmental sector in Qatar serving the older adult population.
Methods: Utilising the CFIR, this study analysed feedback from healthcare professionals through FGs at HMC. A combined inductive and deductive thematic analysis was applied to transcripts from five FGs, focusing on identifying barriers and enablers to safe medication management among older adults. Two researchers transcribed the audio-recorded FG discussions verbatim, and two researchers analysed the data using a mixed inductive and deductive thematic analysis approach utilising CFIR constructs.
Results: We engaged 53 healthcare professionals (31 physicians, 10 nurses and 12 clinical pharmacists) in FGs. The analysis identified current barriers and enabler themes under different CFIR constructs, including inner settings, outer settings, individual characteristics and intervention characteristics. We identified 44 themes, with 25 classifieds as barriers and
19 as enablers. The findings revealed that barriers and enablers within the inner settings were primarily related to structural characteristics, resources, policies, communication and culture. On the other hand, barriers and enablers from the outer settings included patients and caregivers, care coordination, policies and laws, and resources.
Conclusion: This study identified several barriers and enablers to promote medication management for older adults using the CFIR constructs from the perspective of healthcare professionals. The multifaceted findings emphasise involving stakeholders like clinical leaders, policymakers and decision-makers to address medication safety factors. A robust action plan, continuously monitored under Qatar’s national strategy, is vital. Further research is needed to implement recommended interventions.
| Original language | English |
|---|---|
| Number of pages | 20 |
| Journal | Therapeutic Advances in Drug Safety |
| Volume | 15 |
| Early online date | 7 Oct 2024 |
| DOIs | |
| Publication status | Published - 7 Oct 2024 |
Bibliographical note
We want to express our sincere gratitude to Dr Abdelaziz Darwish, Deputy Chief Medical Officer and A/CEO of RH, for his invaluable support and guidance throughout this research project, Dr Hanadi, chairperson of the Geriatric and Medical Director of the Geriatric department, and Dr Ahmed Al-Mohammed, Head of the medicine department, Dr. YoussefAlmoslimani, Medical Director of Hamad General Hospital, and Dr Nasser Masoudi for their support in securing the necessary resources and facilitating access to facilities subjects]. Their continuous encouragement and belief in the significance of our research motivated us to overcome challenges and strive for excellence. We would also like to thank the entire RH, Medicine, and Mental Department team for their support and collaboration throughout this project. Their contributions have been invaluable to the successful completion of this research.
Lastly, we thank the Medical Research Center (MRC) for funding this research and providing Research Assistant Dr. Ahmed Fouad. We appreciate his effort. We also thank all the participants and individuals who generously devoted their time and effort to this study. Without their cooperation, this research would not have been possible.
Data Availability Statement
All anonymised data are available from the Primary Investigator upon request for academic purposesFunding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The presented work is a component of a broader quality improvement initiative investigating the potential obstacles and facilitators to safe prescribing for older adults in Qatar. This project has been conducted under the approval of the Medical Research Centre, Qatar. MRC in HMC (MRC-01-18-426).
| Funders | Funder number |
|---|---|
| Hamad Medical Corporation | MRC-01-18-426 |
Keywords
- Barriers and enablers
- Clinical Decision Support Systems (CDS)
- Consolidated Framework for Implementation Research (CFIR)
- Deprescribing
- Medication Therapy Management (MTM)
- Older Adults
- Patient engagement
- Polypharmacy
- Potentially Inappropriate Medication (PIM)
- Safe medication management
Access to Document
- Alyazeedi_etal_TADS_Enhancing_medication_management_VOR
https://creativecommons.org/licenses/by-nc/4.0/