Is it time for greater patient involvement to enhance transitional medication safety?

Grimes, Tamasine

doi:10.1136/bmjqs-2021-014116

Cited by 5 publications

(2 citation statements)

References 26 publications

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“…The WHO Report on Medication Safety in Transitions of Care highlights the importance of engaging with, and empowering patients, families and caregivers so that they can be involved in ‘preventing, identifying and taking early action to minimise harm associated with medication’ 18. It has been reported that patient involvement in care transitions is often lacking 19. A qualitative study reporting on the patient perspective of the discharge process concluded that early patient involvement and communication were needed to support the needs of patients at discharge 20.…”

Section: Implementation Issues For Interventions On Transition From I...mentioning

confidence: 99%

Transition of care from adult intensive care settings – implementing interventions to improve medication safety and patient outcomes

2022

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Section: Implementation Issues For Interventions On Transition From I...mentioning

confidence: 99%

Transition of care from adult intensive care settings – implementing interventions to improve medication safety and patient outcomes

2022

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“…A potential solution to deficits in communication across healthcare systems is individual patient or carer involvement in managing their medicines 9 10. Supporting patient participation in managing medicines has numerous benefits: improving information transfer, reducing errors, empowering patients and leading to improved health outcomes 9 11. There is evidence that patients can have a crucial role in identifying and managing medication errors during care transitions 12.…”

Section: Introductionmentioning

confidence: 99%

‘Everyone should know what they’re on’: a qualitative study of attitudes towards and use of patient held lists of medicines among patients, carers and healthcare professionals in primary and secondary care settings in Ireland

O’Donovan¹,

Kirke

Pate

et al. 2022

BMJ Open

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ObjectivesManaging multiple medicines can be challenging for patients with multimorbidity, who are at high risk of adverse outcomes, for example, hospitalisation. Patient-held medication lists (PHMLs) can contribute to patient safety and potentially reduce medication errors. The aims of this study are to investigate attitudes towards and use of PHMLs among healthcare professionals (HCPs), patients and carers.DesignQualitative study based on 39 semistructured telephone interviews.SettingPrimary and secondary care settings in Ireland.ParticipantsTwenty-one HCPs and 18 people taking medicines and caregivers.MethodsTelephone interviews were conducted with HCPs, people taking multiple medicines (5+ medicines) and carers of people taking medicines who were purposively sampled via social media, patient groups and research collaborators. Interviews were transcribed and thematically analysed based on the Framework approach, with the Consolidated Framework for Implementation Research and Theoretical Domains Framework.ResultsThree core themes emerged: (1) attitudes to PHML, (2) function and preferred features of PHML and (3) barriers and facilitators to future use of PHML. All participating (patients/carers and HCP) groups considered PHML beneficial for patients and HCPs (eg, empowering for patients and improved adherence). While PHML were used in a variety of situations such as emergencies, concerns about their accuracy were shared across all groups. HCPs and patients differed on the level of detail that should be included in PHML. HCPs’ time constraints, patients’ multiple medicines and cognitive impairments were reported barriers. Key facilitators included access to digital/compact lists and promotion of lists by appropriate HCPs.ConclusionsOur findings provide insight into the factors that influence use of PHML. Lists were used in a variety of settings, but there were concerns about their accuracy. A range of list formats and encouragement from key HCPs could increase the use of PHML.

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Implementation of medication reconciliation at admission and discharge in Ministry of Defense Health Services hospitals: a multicentre study

Alghamdi,

Alhrasen,

Kassem

et al. 2023

BMJ Open Qual

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There is potential for many medication errors to occur due to the complex medication use process. The medication reconciliation process can significantly lower the incidence of medication errors that may arise from an incomplete or inaccurate medication history as well as reductions in length of hospital stay, patients’ readmissions and lower healthcare costs.The quality improvement collaborative project was conducted as a pilot study in two hospitals, then implemented on a broader scale in 18 hospitals in Saudi Arabia. The goal of the project was to reduce the percentage of patients with at least one outstanding unintentional discrepancy at admission by 50%, over 16-month period (July 2020–November 2021). Our interventions were based on the High 5’s project medication reconciliation WHO, and Medications at Transitions and Clinical Handoffs toolkit for medication reconciliation by Agency for Healthcare Research and Quality. Improvement teams used the Institute of Healthcare Improvement’s (IHI’s) Model for improvement as a tool for testing and implementing changes. Collaboration and learning between hospitals were facilitated by conducting learning sessions using the IHI’s Collaborative Model for Achieving Breakthrough Improvement. The improvement teams underwent three cycles.By the end of the project significant improvements were observed. The percentage of patients with at least one outstanding unintentional discrepancy at admission showed a 20% reduction (27% before, 7% after; p value <0.05) (Relative Risk (RR) 0.74) with a mean reduction in the number of discrepancies per patient by 0.74. The percentage of patients with at least one outstanding unintentional discrepancy at discharge showed 12% reduction (17% before, 5% after; p value <0.05) (RR 0.71) with a mean reduction in the number of discrepancies per patient by 0.34.Compliance to medication reconciliation documentation within 24 hours of admission and discharge showed significant improvement by an average of 17% and 24%, respectively. Additionally, the implementation of medication reconciliation had a negative correlation with the percentage of patients with at least one outstanding unintentional discrepancy at admission and discharge.

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Is it time for greater patient involvement to enhance transitional medication safety?

Cited by 5 publications

References 26 publications

Transition of care from adult intensive care settings – implementing interventions to improve medication safety and patient outcomes

Transition of care from adult intensive care settings – implementing interventions to improve medication safety and patient outcomes

‘Everyone should know what they’re on’: a qualitative study of attitudes towards and use of patient held lists of medicines among patients, carers and healthcare professionals in primary and secondary care settings in Ireland

Implementation of medication reconciliation at admission and discharge in Ministry of Defense Health Services hospitals: a multicentre study

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