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SelfMED: Self-Administration of Medication in Hospital: A Prevalence Study in Flanders, Belgium
Toke Vanwesemael1, Bart Van Rompaey2, Mirko Petrovic3
1Department of Healthcare, Thomas More University College, Belgium and Department of Nursing Science and Midwifery, Centre for Research and Innovation in Care (CRIC), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
Background:
Self-management is a key element in regaining and maintaining health. However, during hospitalization it becomes less obvious. Patient self-administration of medication during hospitalization is suggested to be beneficial to patient satisfaction, adherence to pharmacotherapy, and self-care competence.
Objectives:
This study aimed to examine the prevalence of self-administration of medication during hospitalization, and possible contributing factors.
Design And Setting:
A cross-sectional observational study was conducted in 12 Belgian hospitals from February 2015 until June 2015.
Participants:
Data were collected on all hospitalized patients at 57 wards, based in 12 hospitals.
Data Collection:
A structured questionnaire at ward level and patient level on medication management, self-administration of medication, and rationale for prohibiting or allowing patients to self-administer their medication was conducted in consultation with the head nurse.
Results:
Of the 1,269 patients participating in this study, 22% self-administered at least one medicine during hospitalization and 13.8% self-administered at least 50% of their total amount of medication. In the opinion of the head nurse, 40.9% of the hospitalized patients would have been able to self-administer their medication during hospitalization. Only a few wards had an available procedure and screening tool to assess the competence of the patients to self-administer their medication. This did not affect the prevalence of self-administration. Self-administration occurred significantly more at surgical short-stay wards, compared to other wards. The self-administering patients were on average younger and female and had a lower number of different medications per day before and during hospitalization. These patients had a good health status and were independent to mildly dependent on nurses on the ward. Related factors were used to provide a multivariate logistic regression model.
Conclusions:
Sometimes self-administration of medication was allowed. According to the surveyed nurses, however, more patients would be able to self-administer their medication during hospitalization. There seems to be a lack of procedures and screening tools to assess the competence or appropriateness of patients to self-administer their medication.
Clinical Relevance:
This study provides new knowledge about the prevalence of self-administration of medication, contributing factors, the types of self-administered medications, and the organization of self-administration of medication on different wards.