A web application to involve patients in the medication reconciliation process: a user-centered usability and usefulness study

Marien, Sophie; Legrand, Delphine; Ramdoyal, Ravi; Nsenga, Jimmy; Ospina, Gustavo; Ramon, V.; Boland, Benoît; Spinewine, Anne

doi:10.1093/jamia/ocy107

Cited by 15 publications

(38 citation statements)

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“…Patients were generally satisfied with the patient portal medication reconciliation method, compared to earlier results. 11,12 Although patients in the usual care group were significantly more satisfied with the medication reconciliation method than patients in the patient portal group, the difference was small. Both patient groups indicated that they preferred medication reconciliation at home above medication reconciliation in the hospital.…”

Section: Discussionmentioning

confidence: 97%

“…10e13 Patients are generally satisfied with using the patient portal and think that it could improve communication about medication with health care professionals. 12 Although these studies show that patients can have a role in medication reconciliation, to our knowledge no studies have been performed in which the quality of patient portal medication reconciliation was compared to medication reconciliation by a pharmacy professional.…”

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confidence: 99%

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The Effect of Medication Reconciliation via a Patient Portal on Medication Discrepancies: A Randomized Noninferiority Study

Ebbens

Gombert-Handoko

Wesselink

et al. 2021

Journal of the American Medical Directors Association

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Background: Medication reconciliation has become standard care to prevent medication transfer errors. However, this process is time-consuming but could be more efficient when patients are engaged in medication reconciliation via a patient portal. Objectives: To explore whether medication reconciliation by the patient via a patient portal is noninferior to medication reconciliation by a pharmacy technician. Design (including intervention): Open randomized controlled noninferiority trial. Patients were randomized between medication reconciliation via a patient portal (intervention) or medication reconciliation by a pharmacy technician at the preoperative screening (usual care). Setting and Participants: Patients scheduled for elective surgery using at least 1 chronic medication were included. Measures: The primary endpoint was the number of medication discrepancies compared to the electronic nationwide medication record system (NMRS). For the secondary endpoint, time investment of the pharmacy technician for the medication reconciliation interview and patient satisfaction were studied. Noninferiority was analyzed with an independent t test, and the margin was set at 20%. Results: A total of 499 patients were included. The patient portal group contained 241 patients; the usual care group contained 258 patients. The number of medication discrepancies was 2.6 AE 2.5 in the patient portal group and 2.8 AE 2.7 in the usual care group. This was not statistically different and within the predefined noninferiority margin. Patients were satisfied with the use of the patient portal tool. Also, the use of the portal can save on average 6.8 minutes per patient compared with usual care. Conclusions and Implications: Medication reconciliation using a patient portal is noninferior to medication reconciliation by a pharmacy technician with respect to medication discrepancies, and saves time in the medication reconciliation process. Future studies should focus on identifying patient characteristics for successful implementation of patient portal medication reconciliation.

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Section: Discussionmentioning

confidence: 97%

mentioning

confidence: 99%

The Effect of Medication Reconciliation via a Patient Portal on Medication Discrepancies: A Randomized Noninferiority Study

Ebbens

Gombert-Handoko

Wesselink

et al. 2021

Journal of the American Medical Directors Association

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“…Patients who use an online personal health record (PHR)—a secure online website that gives patients access to personal health information—are able to relatively accurately record a list of their medication [ 33 , 34 ]. Although PHRs facilitate patient empowerment and broad implementation of MR, more medication discrepancies are identified with MR performed by a healthcare professional than with an online PHR used by patients [ 35 ].…”

Section: Introductionmentioning

confidence: 99%

“…Knowledge of these risk factors will give insight into how to target patients for whom MR can safely be performed through use of a PHR. Currently, only one small study (n = 13) investigated the association between patient characteristics and deviations between the medication list documented by the patient in the PHR, compared to the best possible medication history [ 34 ]. This study did not find an association between risk factors (such as age, sex, previous IT use, number of medications or pattern of use) and the number of deviations.…”

Section: Introductionmentioning

confidence: 99%

“…This study did not find an association between risk factors (such as age, sex, previous IT use, number of medications or pattern of use) and the number of deviations. However, limitations of this study were the number of included patients and the number of variables studied [ 34 ]. So, more insight into the effects of patient-, setting-, and medication-related factors is necessary.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for clinically relevant deviations in patients’ medication lists reported by patients in personal health records: a prospective cohort study in a hospital setting

et al. 2022

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Background Personal health records have the potential to identify medication discrepancies. Although they facilitate patient empowerment and broad implementation of medication reconciliation, more medication discrepancies are identified through medication reconciliation performed by healthcare professionals. Aim We aimed to identify the factors associated with the occurrence of a clinically relevant deviation in a patient’s medication list based on a personal health record (used by patients) compared to medication reconciliation performed by a healthcare professional. Method Three- to 14 days prior to a planned admission to the Cardiology-, Internal Medicine- or Neurology Departments, at Amphia Hospital, Breda, the Netherlands, patients were invited to update their medication file in their personal health records. At admission, medication reconciliation was performed by a pharmacy technician. Deviations were determined as differences between these medication lists. Associations between patient-, setting-, and medication-related factors, and the occurrence of a clinically relevant deviation (National Coordinating Council for Medication Error Reporting and Prevention class $$\ge$$ ≥ E) were analysed. Results Of the 488 patients approached, 155 patients were included. Twenty-four clinically relevant deviations were observed. Younger patients (adjusted odds ratio (aOR) 0.94; 95%CI:0.91–0.98), patients who used individual multi-dose packaging (aOR 14.87; 95%CI:2.02–110), and patients who used $$\ge$$ ≥ 8 different medications, were at highest risk for the occurrence of a clinically relevant deviation (sensitivity 0.71; specificity 0.62; area under the curve 0.64 95%CI:0.52–0.76). Conclusion Medication reconciliation is the preferred method to identify medication discrepancies for patients with individual multi-dose packaging, and patients who used eight or more different medications.

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A qualitative study of factors influencing ePHR adoption by caregivers and care providers of Alzheimer's patients: An extension of the unified theory of acceptance and use of technology model

Amiri

Pirnejad

Bahaadinbeigy

et al. 2023

Health Science Reports

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Background and Aims: As the nowadays provision of many healthcare services relies on technology, a better understanding of the factors contributing to the acceptance and use of technology in health care is essential. For Alzheimer's patients, an electronic personal health record (ePHR) is one such technology. Stakeholders should understand the factors affecting the adoption of this technology for its smooth implementation, adoption, and sustainable use. So far, these factors have not fully been understood for Alzheimer's disease (AD)-specific ePHR. Therefore, the present study aimed to understand these factors in ePHR adoption based on the perceptions and views of care providers and caregivers involved in AD care.Methods: This qualitative study was conducted from February 2020 to August 2021 in Kerman, Iran. Seven neurologists and 13 caregivers involved in AD care were interviewed using semi-structured and in-depth interviews. All interviews were conducted through phone contacts amid Covid-19 imposed restrictions, recorded, and transcribed verbatim. The transcripts were coded using thematic analysis based on the unified theory of acceptance and use of technology (UTAUT) model. ATLAS.ti8 was used for data analysis.Results: The factors affecting ePHR adoption in our study comprised subthemes under the five main themes of performance expectancy, effort expectancy, social influence, facilitating conditions of the UTAUT model, and the participants' sociodemographic factors. From the 37 facilitating factors and 13 barriers identified for ePHR adoption, in general, the participants had positive attitudes toward the ease of use of this system. The stated obstacles were dependent on the participants' sociodemographic factors (such as age and level of education) and social influence (including concern about confidentiality and privacy). In general, the participants considered ePHRs efficient and useful in increasing neurologists' information about Health Sci. Rep.

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A web application to involve patients in the medication reconciliation process: a user-centered usability and usefulness study

Abstract: Our findings highlight the importance and value of user-centered usability testing of a patient application implemented in "real-world" conditions. To achieve adoption and sustained use by patients, the app should meet patients' needs while also efficiently improving the quality of MedRec.

Cited by 15 publications

References 50 publications

The Effect of Medication Reconciliation via a Patient Portal on Medication Discrepancies: A Randomized Noninferiority Study

The Effect of Medication Reconciliation via a Patient Portal on Medication Discrepancies: A Randomized Noninferiority Study

Risk factors for clinically relevant deviations in patients’ medication lists reported by patients in personal health records: a prospective cohort study in a hospital setting

A qualitative study of factors influencing ePHR adoption by caregivers and care providers of Alzheimer's patients: An extension of the unified theory of acceptance and use of technology model

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