Home care nurses’ contribution to pharmaceutical care

Abstract

Many older patients take multiple medicines each day. The patients, and sometimes their informal caregiver, have responsibility to manage the medication therapy as well as to reach the desired health outcomes. Healthcare professionals, such as home care nurses, also play a role in the medication therapy.

This dissertation provides insight into the contribution of home care nurses to the pharmaceutical care of the patients. In this dissertation it was examined how older patients self-manage the use of their medication and how they experience support from home care nurses. Besides, potential problems such as the lack of information about changes in medication for home care nurses and the consequences for patients if problems result in administration errors have been described. Furthermore, collaboration between the healthcare professionals regarding the home care nurses’ activities for the support of pharmacists’ and general practitioners’ work in a clinical medication review and home care nurses’ competences were explored.

This dissertation shows that older patients have problems with organizing their medication intake, do not adequately discuss medication use and problems with their caregiver. It also shows that storage and disposal of medication is not always done correctly. Patients indicate that home care nurses’ support helps them with the medication self-management. This dissertation also shows that home care nurses can contribute to collaboration with healthcare professionals by observing potential medication-related problems, patient preferences and medication efficacy, and providing patient information and education. Finally, 60 nursing competences for pharmaceutical care has been described in detail.

Home care nurses have an essential contribution to pharmaceutical care, for example in a clinical medication review, but there is room for improvement. Collaboration between healthcare professionals would benefit from regular medication consultation, the more frequent use of modern tools for efficient communication such as smartphone apps. Also more attention to medication in the education programs of nurses and in lifelong training, preferably together with other healthcare professionals, would benefit the home care nurses.