Nursing homes face major challenges over the issue of control of medication for older people. This is according to new research Adherence with medication in nursing homes for older people: resident enforcement or resident empowerment? by Professor Carmel Hughes and Roz Goldie at Queen’s University. 

The research was carried out to explore the issues surrounding adherence to medication in nursing homes and resident involvement in prescribing and decision-making on medicines. GPs providing care to nursing home residents, nursing home managers and residents from these homes across Northern Ireland were invited to participate in semi-structured interviews and focus groups.  Although adherence with medication is not perceived to be a problem in nursing homes, other aspects of medication use appear to be problematic for GPs and nurses. Both healthcare professionals have highlighted the need for control of the prescribing or administrative processes in order to ensure safety and continuity of care. Control is negatively influenced by poor medication records, polypharmacy, medication side-effects and lack of medication review. All of which affect safety, quality of care and control of disease.

“Control of medication for older people in nursing homes is exerted in order to increase safety and minimise risk, but sometimes this can be at the expense of resident’s independence and appear to result in disempowerment,” said Professor Hughes. “These findings reinforce the need to promote patient-centred care within practice and policy. We found that residents took their medication regularly and only refused it if they thought it was giving rise to side-effects. They accepted control without question and did not appear to want to be involved in prescribing or administration of their own medicines.”