title: Medication management in the older adult: A narrative exploration.
abstract: OBJECTIVE
  The purpose of this study was to characterize the meaning nurse practitioners (NPs) ascribed to personal experiences providing care to older adults who take multiple medications to manage complex conditions. The study illuminated the NP experience in caring for the older adult while addressing the complexities of medication management through narrative stories in practice.
  
  
  METHODS
  NPs self-identifying as caring for older adults were interviewed (N=15). Narrative inquiry and the three-dimensional narrative inquiry space were used to guide the researcher during data collection and analysis.
  
  
  CONCLUSIONS
  Three common themes emerged from the narratives. These themes illuminated the complexities NPs face in managing patients with multiple comorbidities, taking multiple medications, and seeing multiple providers. Identified themes were "mastering the art of the puzzle," "it takes a village," and "power in knowledge." Tools to assist NPs identify and manage polypharmacy were identified including the 2015 updated Beers Criteria, ARMOR (Assess, Review, Minimize, Optimize, and Reassess), STOPP (screening tool of older people's potentially inappropriate prescriptions), and START (screening tool to alert providers to the right treatment) tools.
authors.affiliation: Baylor University Louise Herrington School of Nursing, Dallas, Texas.
authors.forename: Johnanna
authors.initials: J
authors.lastname: Hernandez
mesh_terms: D000328:Adult; D003142:Communication; D003266:Continuity of Patient Care / Q000592:standards; D005260:Female; D005853:Geriatrics / Q000379:methods* / Q000592:standards; D006801:Humans; D008297:Male; D054539:Medication Therapy Management / Q000592:standards*; D008875:Middle Aged; D009722:Nurse Practitioners / Q000639:trends*; D009723:Nurse-Patient Relations; D019338:Polypharmacy; D011320:Primary Health Care / Q000379:methods / Q000592:standards; D036301:Qualitative Research; D000078329:Workforce
keywords: Nurse practitioner; advanced practice nurse; aging; decision making; medication; polypharmacy; qualitative; safety