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Compliance with Medication in Nursing Homes for Older People

Resident Enforcement or Resident Empowerment?

Drugs & Aging volume 25, pages 445–454 (2008)Cite this article

Abstract

Compliance with medication has been frequently cited as a problem for patients living in community settings. However, there has been little commentary on compliance issues for residents in nursing homes. This is probably due to the assumption that residents will receive their medication on a regular basis and administration will be supervised and, therefore, compliance is not perceived to be a problem. However, regular compliance may not always be appropriate if the medication has not been reviewed for appropriateness and this ‘enforced’ compliance may give rise to side effects or adverse effects. Residents may also be exposed to ‘erratic’ compliance because of inconvenient administration times for staff or difficult and time-consuming administration instructions. This may have clinical implications for residents who require medication at regular intervals, e.g. those who have Parkinson’s disease. Enforced or erratic compliance is at odds with shared decision making, which is being promoted as a way of empowering patients. It could be argued that because of a high degree of cognitive impairment, it is not appropriate for nursing home residents to become involved in decision making about medications. However, the nursing home population is heterogeneous in nature and the assumption should not be made that all residents are incapable of becoming more involved in some aspects of their own care. A greater focus on resident-centred care may promote more empowerment and autonomy, both generally and with respect to compliance with medication in particular, in nursing home residents.

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Acknowledgements

At the time of writing, Carmel M. Hughes was supported by a Cochrane Fellowship from the Research and Development Office, Northern Ireland and a grant from Atlantic Philanthropies to conduct a study on compliance with medication in nursing homes for older people. The author has no conflicts of interest that are directly relevant to the content of this article.

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    Carmel M. Hughes

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Hughes, C.M. Compliance with Medication in Nursing Homes for Older People. Drugs Aging 25, 445–454 (2008). https://doi.org/10.2165/00002512-200825060-00001

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Keywords

  • Dementia
  • Nursing Home Resident
  • Trandolapril
  • Residential Home
  • Nursing Home Population