Mrs Savi Tyndale Biscoe
Dr V-Lin Cheong
Why is this study important?
Sub-optimally managed medicines can result in poorer outcomes for older people living with frailty. Medicines are the most common healthcare intervention and frail older people often have complex medicines regimens comprising polypharmacy, requirements for frequent monitoring and dosage adjustments. In patients living with frailty who are already sensitive to minor stressors, complex medicines regimens can result in further instability and deterioration of their frail state. Increased complexity of medication regimens is associated with non-adherence and medication errors, increased risk of hospitalisation and a subsequent disruption in the stability of medication regimen.
We know from our own research that patients living at home with chronic conditions need to navigate large and multi-professional networks of support in order to safely manage their medicines. Previous research also showed that a considerable number of people living at home and their informal carers would benefit from greater skills and knowledge to enable effective self-management of medicines. This includes managing daily routines, and recognising when and how to seek help if they think mistakes have been made, begin to feel unwell and need to escalate their concerns.
This research aims to explore and improve how older people with mild and moderate frailty and their carers self-manage their medicines using the theory of resilience in healthcare.
Specifically, our research objectives are to:
1 Conduct qualitative research to map the range of strategies used to self-manage medicines of mild and moderately frail older patients and their support networks.
2 Understand how patients and their support networks might anticipate potential system failure, respond to problems they encounter with their medicines or when they perceive deterioration and require support.
3 Critically appraise how the overall medicines management system facilitates older people living with frailty to self-manage their medicines at home.
4 Conduct a rapid review of self-management of medicines intervention components that might enhance healthcare resilience.
5 Co-design with patients and primary care staff a resilience-based intervention to support effective self-management of medicines that is flexible to cope with changes in type and quantity of medicines for varying and fluctuating conditions.
6 Iteratively prototype the intervention by assessing potential barriers and facilitators to its use.