Date Presented 04/04/19
Exploring and understanding OTs’ experiences of working with home healthcare clients to manage their medication will provide useful information to develop appropriate medication management guidelines and competency standards to improve overall OT in home healthcare practice. OTs who know their role in medication management and are well-informed about medication can collaborate with the home healthcare team more effectively.
Primary Author and Speaker: Julie Blum
Additional Authors and Speakers: Jennifer Fogo, Judith Malek-Ismail
BACKGROUND: Many community dwelling adults do not adhere to their medication regimen resulting in high rates of emergency department visits and subsequent hospital admissions. Occupational therapists, as members of the home health care team, provide medication management within the occupational therapy scope of practice. Occupational therapy practitioners can contribute effectively to medication management (Schwartz & Smith, 2016), by identifying the problems that make it difficult for clients to adhere to a medication routine and help them integrate medication administration into their individualized daily life routines. Occupational therapists practicing in home health can apply the AOTA’s position, teaching clients adaptive strategies, modifying activities to manage the physical demands of chronic condition, and helping clients develop behaviors and routines to support physical and psychosocial health and well-being in their home environment. These health management activities involve medication management as termed in The Occupational Therapy Practice Framework: Domain and Practice, 3
rd
ed. (AOTA, 2014). Even though it has been suggested in the literature that occupational therapists can address medication management with detailed strategies (Guariglia & Smallfield, 2015), there is a need for data-driven studies because it is unknown to what extent these strategies may be utilized in home health care practice. What are the experiences of occupational therapists’ with involvement in medication management in home health care practice?
DESIGN/ METHODS: The researchers used purposive and snowball sampling to select occupational therapists who had a minimum of one year experience in home health care and worked with clients who take medication. Nine occupational therapists practicing in home health care were interviewed. The researcher used a semistructured interview guide that included closed-ended questions to collect demographic and descriptive information about the participants and open-ended questions to explore the participants’ views, and beliefs to understand the meaning of their experiences of providing medication management with home health care clients. Using a qualitative interpretive phenomenological study, the researchers explored the participants’ experiences addressing medication management.
RESULTS: The researchers identified three themes: professional reasoning, inter-professional involvement, and professional competence and confidence. The participants reported that they were addressing medication management in accordance with occupational therapy scope of practice; however, they did not feel confident because of their lack of knowledge about pharmacology.
CONCLUSION: Preparing entry level occupational therapy students and practicing occupational therapists with interprofessional education about medication management will improve occupational therapists’ competence and confidence. Occupational therapists who know their role in medication management and are well-informed about medication can collaborate with the home health care team more effectively.
References
American Occupational Therapy Association [AOTA]. (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68, S1-S48. https://doi.org/10.5014/ajot.2014.682006
Guariglia, S. & Smallfield, S. (2015, March). The role of occupational therapy in medication management in acute care. Gerontology Special Interest Section Quarterly, 38(1), 1-3. Retrieved from https://www.aota.org/∼/media/Corporate/Files/Secure/Publications/SIS-Quarterly-Newsletters/G/GSIS-March-2015.pdf
Schwartz, J. K. & Smith, R. O. (2017). Integration of medication management into occupational therapy practice. American Journal of Occupational Therapy, 71, 710436001p1-710436001p7. https://doi.org/10.5014/ajot.2017.015032
Siebert, C. & Schwartz, J. (2017). Occupational therapy’s role in medication management. American Journal of Occupational Therapy, 71, 7112410025p1-7112410025p20. https://doi.org/10.5014/ajot.2017.716S02
