A qualitative study of patient involvement in medicines management after hospital discharge: an under-recognised source of systems resilience

Author:

Fylan BethORCID,Armitage Gerry,Naylor Deirdre,Blenkinsopp Alison

Abstract

IntroductionThere are risks to the safety of medicines management when patient care is transferred between healthcare organisations, for example, when a patient is discharged from hospital. Using the theoretical concept of resilience in healthcare, this study aimed to better understand the proactive role that patients can play in creating safer, resilient medicines management at a common transition of care.MethodsQualitative interviews with 60 cardiology patients 6 weeks after their discharge from 2 UK hospitals explored patients’ experiences with their discharge medicines. Data were initially subjected to an inductive thematic analysis and a subsequent theory-guided deductive analysis.ResultsDuring interviews 23 patients described medicines management resilience strategies in two main themes: identifying system vulnerabilities; and establishing self-management strategies. Patients could anticipate problems in the system that supplied them with medicines and took specific actions to prevent them. They also identified when errors had occurred both before and after medicines had been supplied and took corrective action to avoid harm. Some reported how they had not foreseen problems or experienced patient safety incidents. Patients recounted how they ensured information about medicines changes was correctly communicated and acted upon, and described their strategies to enhance their own reliability in adherence and resource management.ConclusionPatients experience the impact of vulnerabilities in the medicines management system across the secondary–primary care transition but many are able to enhance system resilience through developing strategies to reduce the risk of medicines errors occurring. Consequently, there are opportunities—with caveats—to elicit, develop and formalise patients’ capabilities which would contribute to safer patient care and more effective medicines management.

Publisher

BMJ

Subject

Health Policy

Reference60 articles.

1. ‘Global Trigger Tool’ Shows That Adverse Events In Hospitals May Be Ten Times Greater Than Previously Measured

2. Temporal Trends in Rates of Patient Harm Resulting from Medical Care

3. A review of medication incidents reported to the National Reporting and Learning System in England and Wales over 6 years (2005-2010)

4. The World Health Organization. WHO Global Patient Safety Challenge: Medication Without Harm. 2017 http://www.who.int/patientsafety/medication-safety/medication-without-harm-brochure/en (accessed 23 Jun 2017).

5. The World Health Organization. The High 5s Project Interim Report. 2014 http://www.who.int/patientsafety/implementation/solutions/high5s/High5_InterimReport.pdf?ua=1 (accessed 23 Jun 2017).

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