Shared Medication PLanning In Home Hospice to Address Medication Regimen Complexity and Family Caregiver Burden: A Brief Report.

IF 2.2 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES Journal of palliative medicine Pub Date : 2024-12-01 Epub Date: 2024-10-28 DOI:10.1089/jpm.2024.0229

Jennifer Tjia, Margaret F Clayton, Geraldine Puerto, Vennesa Duodu, Francesca Troiani, Sruthi Tanikella, Susan DeSanto-Madeya

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Abstract

Objective: Medication management in home hospice is challenging for family caregivers (FCGs). We tested a patient-centered medication review and FCG support program delivered by hospice staff called "Shared Medication PLanning In (SiMPLIfy) Home Hospice." Methods: A pilot cluster-randomized trial at two U.S. home hospice agencies measured the primary outcome of reduction in Medication Regimen Complexity Index (MRCI) (range 0 [no medications]-no upper limit) and secondary outcome of Family Caregiver Medication Administration Hassle Scale (FCMAHS) (range 0 [no hassle-120 [greatest hassle]). Results: Twenty-two patient-FCG dyads enrolled. Mean baseline MRCI in the intervention group = 39 (95% CI: 30.9, 47.1) and control group = 25.5 (95% CI: 21.0-30.1). Half of intervention patients (3 of 6) had reduced MRCI compared with 26.7% (4 of 15) control patients (p = 0.07). MRCI was not significantly associated with caregiver burden. FCMAHS differed between spousal and nonspousal FCGs (p = 0.12). Conclusion: A clinician-FCG-patient communication program in home hospice is feasible and may reduce medication complexity. SiMPLIfy has the potential to reduce polypharmacy.

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居家安宁疗护中的共同用药计划，以解决用药方案的复杂性和家庭护理者的负担：简要报告。

目的：居家安寧療護的藥物管理對於家庭照護者（FCGs）來說是一項挑戰。我们测试了一项由安宁疗护人员提供的以患者为中心的用药审查和家庭照护者支持计划，名为 "居家安宁疗护中的共同用药计划（SiMPLIfy）"。方法：在美国两家居家安宁疗护机构进行了分组随机试验，测量的主要结果是用药方案复杂性指数（MRCI）的降低（范围为0[无药物]-无上限），次要结果是家庭照护者用药管理麻烦量表（FCMAHS）的降低（范围为0[无麻烦-120[最麻烦]）。结果：22对患者-FCG组合参加了研究。干预组平均基线 MRCI=39（95% CI：30.9，47.1），对照组平均基线 MRCI=25.5（95% CI：21.0-30.1）。半数干预组患者（6 例中的 3 例）的 MRCI 降低，而对照组患者的 MRCI 降低率为 26.7%（15 例中的 4 例）（P = 0.07）。MRCI 与照顾者的负担无明显关联。有配偶和无配偶的 FCG 之间的 FCMAHS 有差异（p = 0.12）。结论在居家临终关怀中实施临床医生-FCG-患者沟通计划是可行的，并可降低用药复杂性。SiMPLIfy有可能减少多重用药。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of palliative medicine 医学-卫生保健

CiteScore

3.90

自引率

10.70%

发文量

345

审稿时长

2 months

期刊介绍： Journal of Palliative Medicine is the premier peer-reviewed journal covering medical, psychosocial, policy, and legal issues in end-of-life care and relief of suffering for patients with intractable pain. The Journal presents essential information for professionals in hospice/palliative medicine, focusing on improving quality of life for patients and their families, and the latest developments in drug and non-drug treatments. The companion biweekly eNewsletter, Briefings in Palliative Medicine, delivers the latest breaking news and information to keep clinicians and health care providers continuously updated.