Self-administration of medication in hospital: patients\u27 perspectives

Background. Little information is available about patients\u27 perspectives on self- or nurse-related administration of medication.Aim. The aim of the study was to determine patients\u27 perspectives about self-medication in the acute care setting.Methods. A qualitative approach, using in-depth semi-structured interviews, was taken. Ten patients with a chronic medical illness who had experienced multiple hospital admissions for treatment were interviewed about their experiences of medication administration in the acute care setting. Participants were recruited from two cardiovascular wards in a private, not-for-profit hospital in Melbourne, Australia. Data collection occurred between August and September 2002.Findings. Four major themes were identified from the interviews: benefits of self-administration, barriers to self-administration, assessing appropriateness of self-administration and timing of medication administration. Seven participants had previously experienced self-administration of medications and six were in favour of this practice in the clinical setting. Nine managed their own medications at home, and one self-administered with some assistance from his family. Participants were very concerned about how nurses\u27 heavily regulated routines affected delivery of medications in hospital and disrupted individualized plans of care maintained in the home setting.Conclusions. In planning and implementing self-administration programmes, it is important to consider patients\u27 views. Medication regimes should be simple and flexible enough to adapt to patients\u27 lifestyles and usual routines. Nurses should also take advantage of opportunities to support and facilitate patient autonomy, to enable more effective management of health care needs when patients return home.