Introduction: Inappropriate medication management may lead to polymedicated home-dwelling older adults having medication-related problems (MRPs), particularly during care transitions. MRPs are often responsible for physical and cognitive decline, avoidable health costs, and early death. Optimizing medication management should be a priority to prevent MRPs. Nurses’ roles in ensuring safe medication management for this population remain poorly explored. Objectives: Develop an interprofessional model to support medication management and prevent MRPs among polymedicated home-dwelling older adults after hospital discharge. Methods: A sequential, explanatory mixed-methods study–conducted from February 2019 to January 2022– investigated medication management among polymedicated home-dwelling older adults after discharge from a hospital in French-speaking Switzerland. The quantitative phase retrospectively examined the hospital’s electronic patient records (N = 105,243) to identify geriatric inpatient profiles at risk of 30-day hospital readmission or unplanned nursing home admission. The qualitative phase explored the perspectives of older adults (n = 28), their informal caregivers (n = 17), and their healthcare professionals (n = 13) on medication management after hospital discharge. A systematic literature review was conducted simultaneously. Results: Retrospective findings revealed patient-, medication-, and environmentrelated factors that increased the risks of polymedicated home-dwelling older adults experiencing hospital readmission or unplanned nursing home admission. Prospective findings revealed poor patient-centeredness and dysfunctions in communication, collaboration, and coordination between the multiple stakeholders involved in postdischarge medication management at home. The combined findings enabled us to design an interprofessional, collaborative medication management model composed of four interactive fields of action: giving voice to polymedicated home-dwelling older adults and their informal caregivers; involving older adults and their informal caregivers in shared, medication-related decision-making; empowering older adults and their informal caregivers for safe medication self-management; and optimizing collaborative medication management practices. Conclusions: Safe, effective post-discharge medication management at home faces numerous hindrances. More nurse-led, interprofessional, patient-centered practices can help improve safe medication management. Future studies should explore the effectiveness of our collaborative, patient-centered medication management model for polymedicated home-dwelling older adults after hospital discharge.
