‘Sometimes we just have to trust our gut feeling and hope the reporting is good’.: Healthcare providers’ experiences of pro re nata medication decision-making in sheltered housing

Objective: Pro re nata (as needed) medications are widely used among older patients in long-term care. Current knowledge of healthcare providers’ administration of these medications and the decisions involving these medications is scarce and mainly relies on data from nursing homes. This study aims to explore how healthcare providers who work in sheltered housing for older people, experience pro re nata decision-making. Design, setting and subjects: This study used qualitative interviews of healthcare providers working in sheltered housing in mid- and eastern Norway (n=8). Data analysis was based on qualitative, latent, content analysis. Results: The analysis showed that the main experiences of the informants in the study involved the challenge of making decisions that give the professionals a good feeling about their decision, the main theme being Searching for comfort when making pro re nata medication decisions. Three sub-themes were identified within this theme: Taking, sharing and shifting responsibility, striving between resident autonomy and appropriate medication use, and struggling with and/or embracing the system. Conclusions: The healthcare providers in this study experienced PRNM decision-making differently. The informants experienced this decision-making to sometimes be challenging, due to the informants wanting to make decisions that are acceptable to both the residents and themselves.