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  • Inappropriate use of medicines in acute care for the elderly related to a focus on acute care, providers’ passive attitudes about learning, and paternalistic decision making

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Qualitative
Inappropriate use of medicines in acute care for the elderly related to a focus on acute care, providers’ passive attitudes about learning, and paternalistic decision making

https://doi.org/10.1136/ebn.9.3.96

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    Spinewine A, Swine C, Dhillon S, et al. Appropriateness of use of medicines in elderly inpatients: qualitative study. BMJ 2005;331:935.OpenUrlAbstract/FREE Full Text

    Q What are the perspectives of healthcare providers and patients on the appropriateness of medication use in elderly patients on acute care hospital wards?

    DESIGN

    Qualitative study.

    SETTING

    Acute care wards for the elderly in 5 hospitals in Belgium.

    PARTICIPANTS

    A purposive sample of 17 patients who were stable, had no cognitive impairment, had ⩾1 modification in chronic medication, and managed their own medication at home; 5 physicians and 4 nurses working on the wards; and 3 hospital pharmacists.

    METHODS

    Data were collected using individual semistructured interviews (doctors, nurses, pharmacists, and 5 patients), focus groups (12 patients), and observation of the main activities on 2 wards (by 2 pharmacists). Interviews and focus groups were taped and transcribed verbatim. Observations of events relating to medicine use were recorded in notes, which were written up in detail using an observation grid. Data were analysed using grounded theory principles from both biomedical and sociological perspectives.

    MAIN FINDINGS

    Most providers felt that prescribing was sometimes inappropriate and that patient counselling was insufficient. 3 categories underpinned the inappropriate …

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    Footnotes

    • For correspondence: MsA Spinewine, School of Pharmacy, Université catholique de Louvain, Brussels, Belgium. anne.spinewine{at}facm.ucl.ac.be

    • Source of funding: Fonds National de la Recherche Scientifique.