RESPECT: RESidents' Participation in the Evaluation and Customization of Therapy
Quality of care in nursing homes (NHs) is questionable. One of the concerns is the high prevalence of inappropriate prescribing. Previous research has shown that performing a medication review during interdisciplinary case conferences (ICCs) can be an answer to this problem. However, the question on how we can include the resident in this process remains. Another concern is the loss of autonomy when moving into a NH, also concerning their medication. No research has been done on how to involve the residents in their own medication management or parts of it. RESPECT builds on the results and experiences of the COME-ON study, where a complex intervention was tested with the aim to optimize the medication use in nursing home residents (NHRs). This intervention consisted of 3 major parts, including ICC, where a resident’s individual medication list was reviewed by the GP, pharmacist and nurse. In a sub-study of COME-ON, the different processes and sub-processes of the medicines pathway were identified, from prescribing over administration and monitoring of the (side-)effects.
The project consists of 6 work packages (WPs). In the first 2 work packages the experiences and expected level of involvement of the NHRs and their caregivers will be investigated, as well as the experiences and the perceived opportunities of the health care professionals (HCPs). This will be done in qualitative research, using interviews and focus groups. In the 3rd WP the collected information will be combined to develop multiple models on patient participation in the medicines pathway and in the medication review. WP4 investigates which outcomes of medication reviews matter for residents by performing a literature review and expert panels on person-centered outcomes. Besides this, WP1 and 2 might lead to the identification of additional outcomes, including the level of self-management. Last but not least, in WP5 and 6 will consist of pilot tests using the models and outcomes identified in WP3 and WP4 and process evaluations.