장기요양시설 다학제 약물사용 적정관리 프로그램의 실행 장벽과 개선 방안에 관한 질적 연구

초록

Background: This study aimed to determine the barriers and facilitators to implementing a multidisciplinary medication management program in Korean long-term care facilities (LTCFs) and suggest strategies for its sustainable settlement. Methods: This descriptive qualitative study used focus group interviews with eight facility stakeholders. Data were analyzed via thematic analysis based on the Consolidated Framework for Implementation Research. Results: Three main themes and 10 subthemes emerged. The participants acknowledged the program’s value in improving clinical utility for resident safety and building trust and institutional professionalism. However, the implementation was hindered by structural barriers, including excessive administrative burdens, fragmented communication, and psychological resistance among residents and caregivers. Moreover, concerns regarding sustainability due to a lack of human and material support were identified. To ensure sustainable implementation, the participants emphasized the need to institutionalize direct communication channels, establish new reimbursement models, and introduce incentives associated with the facility accreditation system. Conclusion: Effective medication management in LTCFs tends to be hindered by structural, administrative, and psychological barriers. Its successful implementation requires systemic support, including legal frameworks for direct communication and appropriate reimbursement models, beyond clinical protocols.

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