Disease severity and cognitive capacity impacted significantly on the type and severity of challenges to medication administration experienced. Residents with ‘mild’ dementia were largely compliant with medication; those in moderate to severe stages presented significant challenges caused by behavioural disturbances and those at end-stages were compliant but presented physical obstacles to medication-taking (e.g. swallowing difficulties). Respondents employed a number of strategies to minimise or overcome barriers to medication administration; effective communication (with residents, their families, senior

nursing home staff and other healthcare professionals) was cited as the most effective tool with NU7441 in vitro Birinapant supplier which to meet challenges. All respondents reported that caring for residents with dementia required particular interpersonal skills on the part of the healthcare professional including empathy, patience and respect for personhood. In moderate stages

of disease nursing home managers and nursing staff felt strongly about the ethical implications of omission of medications perceived to be critical to the health of the resident (e.g. cardiovascular drugs) and sought the expertise of community pharmacists in ensuring residents’ adherence to these medications. Training on alternative formulations and identifying and managing pain for residents with dementia were identified as key requirements for staff. Community pharmacists were seen as an appropriate and valuable source of this training. Nursing home staff face a number of significant challenges when administering medications to residents with dementia. Respondents had developed strategies for overcoming these barriers but effective communication was deemed Myosin to be most important. Nursing homes perceived the community pharmacist to be an

invaluable source of expertise, guidance and training on all medication-related aspects of care. These data indicate a growing role for the community pharmacist in care provision for residents with dementia. 1. Care Quality Commission (2011) The state of health care and adult social care in England. An overview of key themes in 2009/10. London: CQC Mark Allman Cwm Taf LHB, Merthyr Tydfil, UK Antibiotics may be over-prescribed for LRTI. Shortness of breath is the most frequently occurring symptom in patients diagnosed with LRTI. Strategies to improve the diagnosis of bacterial disease should be developed to assist clinicians managing patients presenting with symptoms of LRTI. Antibiotics are widely prescribed for patients with lower respiratory tract infection (LRTI) yet only a minority have a pneumonia which responds to antibiotic treatment.