Working in Partnership with Patients/ Clients Who Self Administer Medication
Working in partnership with patients/ clients who self administer medication
A literature review
Self-management has become a concept adopted by the Department of Health (DH) to enable people with chronic health conditions to become the controlling entity over their illness therefore promoting independence and psychological well being. Initiatives that recommend this practice are National Service Framework for chronic disease management and self-care (DH 2002) and National Service Framework for Long-Term Conditions (DH 2005). Part of the framework plan is to implement a strategy to enable people to self-administer their own medication. This includes self-medicating in the community and in acute hospitals.
Compliance and Concordance are terms often used to define principles of self-administering. One must understand their meaning to understand their relevance. Compliance is a word used to describe the act of conforming to a task and non-compliance is a refusal or failure to conform. Concordance is defined as an agreement, a harmony of membership, which can be further implied as a partnership between a couple or group (Soanes and Hawker 2005). The word compliance can be seen to have negative connotation as the act of compliance suggests that one person requires the other to conform by using their perceived higher power. Concordance on the other hand is an equal negotiated consent.
The literature review will look at the nurse’s role in working in partnership with a patient to manage their medicine. A literature review of current peer reviewed articles will allow debate over issues relating to compliance and concordance. Databases used in the literature where CINAHL, OVID and Cochrane Library which offered primary and secondary source, recent publications were used dated between 2002 and 2007. Key words were Self-administration, self-medicating, medication management, and medication with links to adherence, partnership, safety, concordance and
A literature review
Self-management has become a concept adopted by the Department of Health (DH) to enable people with chronic health conditions to become the controlling entity over their illness therefore promoting independence and psychological well being. Initiatives that recommend this practice are National Service Framework for chronic disease management and self-care (DH 2002) and National Service Framework for Long-Term Conditions (DH 2005). Part of the framework plan is to implement a strategy to enable people to self-administer their own medication. This includes self-medicating in the community and in acute hospitals.
Compliance and Concordance are terms often used to define principles of self-administering. One must understand their meaning to understand their relevance. Compliance is a word used to describe the act of conforming to a task and non-compliance is a refusal or failure to conform. Concordance is defined as an agreement, a harmony of membership, which can be further implied as a partnership between a couple or group (Soanes and Hawker 2005). The word compliance can be seen to have negative connotation as the act of compliance suggests that one person requires the other to conform by using their perceived higher power. Concordance on the other hand is an equal negotiated consent.
The literature review will look at the nurse’s role in working in partnership with a patient to manage their medicine. A literature review of current peer reviewed articles will allow debate over issues relating to compliance and concordance. Databases used in the literature where CINAHL, OVID and Cochrane Library which offered primary and secondary source, recent publications were used dated between 2002 and 2007. Key words were Self-administration, self-medicating, medication management, and medication with links to adherence, partnership, safety, concordance and
References: Department of Health (2001) National Service Framework for older people. The Stationary Office, London Department of Health (2002) National service framework for Chronic disease management and self care Department of Health (2005) National Service Framework for Long-Term Conditions. The Stationary Office, London Embrey, N Francis, S-A. Smith, F. Gray, N. Denham, M. (2006) Partnerships between older people and their carers in the management of medication. International Journal of Older People Nursing 1 (4) 201-207 Goodman-Brown, J Grantham, G. McMillan, V. Dunn, S. Gassner, LA. Woodcock, P. (2006) Patient self-medication – a change in hospital practice. Journal of Clinical Nursing 15 (8) 962-970 Haynes, R Haynes, R. Yao, X. Degani, A. Kripalani, S. Garg, A. McDonald, HP. (2005) Interventions for enhancing medication adherence. In: The Cochrane Database of Systematic Reviews, issue 4 Heneghan, CJ Hook, M. L. (2006) Partnering with patients – a concept ready for action. Journal of Advanced Nursing 56 (2) 133-143 Loveridge, N Manias, E. Beanland, C. Riley, R. Baker, L. (2004) Self administration of medication in hospital: patients’ perspectives. Journal of Advanced Nursing 46 (2) 194-203 McGarry Longue, R Metlay, J. Cohen, A. Polsky, D. Kimmel, S. Koppel, R. Hennessy, S. (2005) Medication safety in older adults: home-based practice patterns. Journal of the American Geriatrics Society 53 (6) 976-982 Nagelkerk, J Orwig, D. Brandt, N. Gruber-Baldini, A. (2006) Medication management assessment for older adults in the community. The Gerontologist 46 (5) 661-668 Pinkowish, M Reddy, B. (2006) Medication review as a route to optimising treatment. Nurse Perscribing 4 (11) 464-468 Simpson, R Soanes, C. Hawker, S. (2005) Compact Oxford English Dictionary of Current English (3RD Ed), Oxford University Press, Oxford Taylor, B [available:http://www.jcn.co.uk/journal.asp?MonthNum=03&YearNum=2002&Type=search&ArticleID=444] [accessed 11/03/2007] The Information Centre for Health and Social Care (2006) General Pharmaceutical Services (Annual Bulletin) 2005/06 Ulfvarson, J. Bardage, C. Wredling, A-MR. Von Bahr, C. Adami, J. (2007) Adherence to drug treatment in association with how the patient perceives care and information on drugs. Journal of Clinical Nursing 16 (1) 141-148