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Nurse-led medicines’ monitoring in care homes, implementing the Adverse Drug Reaction (ADRe) Profile improvement initiative for mental health medicines: An observational and interview study

Sue Jordan Orcid Logo, Timothy Banner, Marie Gabe-Walters, Jane M. Mikhail, Gerwyn Panes, Jeff Round, Sherrill Snelgrove, Mel Storey, David Hughes

PLOS ONE, Volume: 14, Issue: 9, Start page: e0220885

Swansea University Authors: Sue Jordan Orcid Logo, David Hughes

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DOI (Published version): 10.1371/journal.pone.0220885

Abstract

This study investigated the implementation and clinical impact of an Adverse Drug Reaction Profile (ADRe) used to assess the prescription regimes of older residents of nursing and care homes. Administration of ADRe was observed for 30 residents prescribed mental health medicines in ten care homes. T...

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Published in: PLOS ONE
ISSN: 1932-6203
Published: 2019
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spelling 2020-10-15T14:18:48.4912454 v2 51807 2019-09-12 Nurse-led medicines’ monitoring in care homes, implementing the Adverse Drug Reaction (ADRe) Profile improvement initiative for mental health medicines: An observational and interview study 24ce9db29b4bde1af4e83b388aae0ea1 0000-0002-5691-2987 Sue Jordan Sue Jordan true false f1fbd458e3c75d8b597c0ac8036f2b88 David Hughes David Hughes true false 2019-09-12 HNU This study investigated the implementation and clinical impact of an Adverse Drug Reaction Profile (ADRe) used to assess the prescription regimes of older residents of nursing and care homes. Administration of ADRe was observed for 30 residents prescribed mental health medicines in ten care homes. The study pharmacist reviewed completed ADRes against medication records. Policy context was explored in 30 interviews with service users, nurse managers and strategic leads in Wales.Residents were aged 60–95, and prescribed 1–17 (median 9 [interquartile range (IQR) 7–13]) medicines. ADRe identified a median of 18 [IQR 11.5–23] problems per resident and nurses made 2 [1–2] changes to care per resident. For example: falls were reported for 9 residents, and care was modified for 5; pain was identified in 8 residents, and alleviated for 7; all 6 residents recognised as dyspnoeic were referred to prescribers. Nurses referred 17 of 30 residents to prescribers. Pharmacists recommended review for all 30. Doubts about administering ADRe, sometimes expressed by people who had not yet used it, diminished as it became familiar. ADRe was needed to bridge communication between resident, nurses and prescribers. When barriers of time, complacency, and doctors’ non-availability were overcome, reporting with ADRe made prescribers more likely to heed nurses’ concerns regarding residents’ welfare. Clinical gains were facilitated by one-to-one time, staff-resident relationships, and unification of documentation. Journal Article PLOS ONE 14 9 e0220885 1932-6203 11 9 2019 2019-09-11 10.1371/journal.pone.0220885 COLLEGE NANME Nursing COLLEGE CODE HNU Swansea University 2020-10-15T14:18:48.4912454 2019-09-12T09:00:23.3721805 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Nursing Sue Jordan 0000-0002-5691-2987 1 Timothy Banner 2 Marie Gabe-Walters 3 Jane M. Mikhail 4 Gerwyn Panes 5 Jeff Round 6 Sherrill Snelgrove 7 Mel Storey 8 David Hughes 9 0051807-19092019150553.pdf 51807.pdf 2019-09-19T15:05:53.6000000 Output 1388899 application/pdf Version of Record true 2019-09-18T00:00:00.0000000 Released under the terms of a Creative Commons Attribution License (CC-BY). true eng
title Nurse-led medicines’ monitoring in care homes, implementing the Adverse Drug Reaction (ADRe) Profile improvement initiative for mental health medicines: An observational and interview study
spellingShingle Nurse-led medicines’ monitoring in care homes, implementing the Adverse Drug Reaction (ADRe) Profile improvement initiative for mental health medicines: An observational and interview study
Sue Jordan
David Hughes
title_short Nurse-led medicines’ monitoring in care homes, implementing the Adverse Drug Reaction (ADRe) Profile improvement initiative for mental health medicines: An observational and interview study
title_full Nurse-led medicines’ monitoring in care homes, implementing the Adverse Drug Reaction (ADRe) Profile improvement initiative for mental health medicines: An observational and interview study
title_fullStr Nurse-led medicines’ monitoring in care homes, implementing the Adverse Drug Reaction (ADRe) Profile improvement initiative for mental health medicines: An observational and interview study
title_full_unstemmed Nurse-led medicines’ monitoring in care homes, implementing the Adverse Drug Reaction (ADRe) Profile improvement initiative for mental health medicines: An observational and interview study
title_sort Nurse-led medicines’ monitoring in care homes, implementing the Adverse Drug Reaction (ADRe) Profile improvement initiative for mental health medicines: An observational and interview study
author_id_str_mv 24ce9db29b4bde1af4e83b388aae0ea1
f1fbd458e3c75d8b597c0ac8036f2b88
author_id_fullname_str_mv 24ce9db29b4bde1af4e83b388aae0ea1_***_Sue Jordan
f1fbd458e3c75d8b597c0ac8036f2b88_***_David Hughes
author Sue Jordan
David Hughes
author2 Sue Jordan
Timothy Banner
Marie Gabe-Walters
Jane M. Mikhail
Gerwyn Panes
Jeff Round
Sherrill Snelgrove
Mel Storey
David Hughes
format Journal article
container_title PLOS ONE
container_volume 14
container_issue 9
container_start_page e0220885
publishDate 2019
institution Swansea University
issn 1932-6203
doi_str_mv 10.1371/journal.pone.0220885
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Nursing{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Nursing
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description This study investigated the implementation and clinical impact of an Adverse Drug Reaction Profile (ADRe) used to assess the prescription regimes of older residents of nursing and care homes. Administration of ADRe was observed for 30 residents prescribed mental health medicines in ten care homes. The study pharmacist reviewed completed ADRes against medication records. Policy context was explored in 30 interviews with service users, nurse managers and strategic leads in Wales.Residents were aged 60–95, and prescribed 1–17 (median 9 [interquartile range (IQR) 7–13]) medicines. ADRe identified a median of 18 [IQR 11.5–23] problems per resident and nurses made 2 [1–2] changes to care per resident. For example: falls were reported for 9 residents, and care was modified for 5; pain was identified in 8 residents, and alleviated for 7; all 6 residents recognised as dyspnoeic were referred to prescribers. Nurses referred 17 of 30 residents to prescribers. Pharmacists recommended review for all 30. Doubts about administering ADRe, sometimes expressed by people who had not yet used it, diminished as it became familiar. ADRe was needed to bridge communication between resident, nurses and prescribers. When barriers of time, complacency, and doctors’ non-availability were overcome, reporting with ADRe made prescribers more likely to heed nurses’ concerns regarding residents’ welfare. Clinical gains were facilitated by one-to-one time, staff-resident relationships, and unification of documentation.
published_date 2019-09-11T04:03:49Z
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