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  11. Engagement With Patients And Families About Managing Medications In Critical Care Units: A Mixed Methods Systematic Review

Engagement with patients and families about managing medications in critical care units: A mixed methods systematic review

Elizabeth Manias1, Rebecca Jarden2, Kelly Ottosen1

  • 1Monash University, Monash Nursing and Midwifery, Wellington Road, Clayton, VIC, 3800, Australia.

Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses
|June 13, 2025

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View abstract on PubMed

Summary
This summary is machine-generated.

Patients and families are mostly informed about medications in critical care, but rarely involved in decision-making. Improving communication can enhance patient and family engagement in medication management.

Area of Science:

  • Critical Care Medicine
  • Patient Engagement
  • Medication Management

Background:

  • Patient and family engagement in medication management within critical care settings is not well understood.
  • Understanding current engagement levels is crucial for improving patient-centered care.

Purpose of the Study:

  • To systematically review and analyze the extent and nature of patient and family engagement in medication management in intensive care units (ICUs).

Main Methods:

  • A mixed-methods systematic review was conducted.
  • Searched five major databases (MEDLINE, CINAHL, PsycINFO, Embase, CENTRAL) from inception to September 2024.
  • Included studies were independently screened, data abstracted, and quality assessed, then mapped onto a continuum of engagement (consultation, involvement, partnership).
Keywords:
Critical careFamily engagementFamily relationshipsHospital

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Main Results:

  • Thirty studies revealed that patients and families primarily engaged through information exchange, valuing bedside communication from nurses, irrespective of patient consciousness.
  • Opportunities for involvement arose when healthcare professionals inquired about patient/family needs and preferences for medications, aiding symptom management.
  • Partnership and shared decision-making were rare; patient and family exclusion was common during professional interactions like handovers and rounds. Interventional studies showed minimal impact on medication safety.

Conclusions:

  • Patients and families encounter significant barriers to engagement, including power differentials and environmental factors.
  • Enhanced communication strategies, such as including family in bedside rounds and scheduled discussions, can improve involvement.
  • Addressing these barriers is key to fostering greater patient and family participation in critical care medication management.
Medication safety
Medication therapy management
Patient engagement
Patient participation
Patient safety
Systematic review