Doctor talking with older patient

Older patients are safer and have better quality care when they and their families are looped into decisions about their medications during care transitions, according to a new perspective published July 31 in the Medical Journal of Australia.

These interactions should be much more than fleeting conversations, say the authors, healthcare quality and safety researchers. But that is not often how they proceed.

These conversations are “rarely organized in a goal-directed way where medication communication is conveyed accurately, clearly and comprehensively,” wrote Elizabeth Manias, of Deakin University in Melbourne, Australia. What’s more, many clinicians view the process of engaging patients and families in these discussions as time-consuming and impractical, she and her colleagues noted.

The ultimate impact of disengaged care is that patients and their families may not be involved in decisions about newly prescribed, discontinued or changed medications. This can lead to problems with medication communication across transitions of care, a key reason for increased risk of medication-related problems and hospital readmissions, Manias and colleagues contend.

“A shift is needed from information-giving and information-receiving consultations to interactive, tailored and deliberate conversations along the continuum of care,” they wrote.

To change this dynamic, the authors suggest that clinicians take the following steps, among others:

  • Communicate about medication throughout the duration of older patients’ care, rather than limited to particular time points;
  • Include families at every opportunity, including bedside discussions and general practitioner discussions, rather than waiting until medication counseling occurs; 
  • Tailor communication to each patient’s ability to comprehend with clear, easy-to-understand language, using resources such as diagrams and photographs of medications;
  • Regularly seek out patient and family priorities and preferences, especially if medication changes are made; and 
  • Practice shared decision making.

The full recommendations can be found in the published article.

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