Oral Medication Administration in Patients with Restrictions on Oral Intake-A Snapshot Survey

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Abstract

Aim:

To determine clinical staff's understanding of managing oral medications in patients with restrictions on oral intake.

Method:

An online survey was designed consisting of 4 scenarios featuring a patient who was fasting pre-surgery, day 1 post-surgery, nil-by-mouth after stroke or had a nasogastric feeding tube in situ. The target population was clinical staff (nursing, medical, pharmacy, dietetics, speech pathology) involved in the management of oral medications and/or patients' oral intake. Medications studied were: aspirin (Cartia) 100 mg mane; gliclazide (Diamicron MR) 60 mg mane; atorvastatin (Lipitor) 40 mg mane; metoprolol (Betaloc) 50 mg bd; levodopa/carbidopa (Sinemet CR) 200/50 tds; ginkgo 7500 complex mane. Respondents could choose to give, withhold, cease, contact someone for advice, change the formulation before giving or choose ‘other’ and make a comment.

Results:

622 responses were received from clinical staff. When fasting, respondents would give metoprolol (65%) and levodopa (68%) but not aspirin (70%), gliclazide (63%), atorvastatin (50%) and ginkgo (65%). Approximately 10% of respondents would give oral medications to the nil-by-mouth patient. The consensus for the nasogastric feeding tube was to give all the medications via the tube, including modified- or controlled-release medications.

Conclusion:

There appeared to be varying understanding of managing oral medications when patients have restrictions on oral intake. This is concerning as it has the potential to result in adverse patient outcomes.

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