Patient involvement in medication safety in hospital: an exploratory study

Abstract

Background Medication errors are common in hospital inpatients. While many interventions have been proposed to address these problems, few have been shown to have significant benefits. A complementary approach is to facilitate greater involvement of patients with their inpatient medication. However, there is relatively little research in this area and it is not known which interventions lead to improved healthcare outcomes. Work is therefore needed to investigate the roles that healthcare professionals and patients believe are appropriate for hospital inpatients to take relating to safety. Objective To explore the extent to which hospital inpatients reported that they engaged with medication safety-related behaviours, the extent to which they would like to, and the extent to which healthcare professionals reported that they would support such engagement. Setting An NHS hospital Trust in West London. Methods 100 Patients and healthcare professionals were recruited on ten wards within the Trust and invited to complete quantitative questionnaires. Data were analysed descriptively and exploratory comparisons made between different groups of respondents. Main outcome measures inpatient medication safety involvement scale and control preference scale for patient involvement in decision making. Results 100 patients (98 % response rate) and 104 healthcare professionals (59 % response rate) were recruited. The majority of patients and healthcare professionals were supportive of hospital inpatients being involved with their medication. However there was a significant gap between desire for patient involvement and what patients reported having experienced. Female patients and those under 65 wanted a significantly higher level of involvement than males and over 65s. Few associations were found between healthcare professionals' reported support for involvement and their profession or gender. However, pharmacists and nurses were significantly more likely to report supporting patients asking questions about their medicines and self administering their own medicines than doctors. Conclusion Healthcare professionals and patients desire a higher level of patient involvement with their medication while in hospital than patients currently report. Interventions need to be developed to bridge the gap between desired and actual patient involvement.

Why are patients not more involved in their own safety? A questionnaire-based survey in a multi-ethnic North London hospital population

“…There may be a gender specific and generational attitude difference in patient response to our questionnaire: the demographic data presented in figures 2 and 3 and table 2 broadly concur with findings expressed by Professor Vincent’s team from London12 and in the exploratory study on medication safety by Mohsin-Shaikh e t al 22 indicating that males and those over 60 years of age showed significantly lower desire for involvement. It is unclear why these groups are less engaged and we can only postulate that older people, who may be already cognitively inhibited, also come from a generation that believes that doctors ‘know best’ and thus, do not feel empowered to challenge healthcare professionals.…”

Parent-Reported Errors and Adverse Events in Hospitalized Children

“…Prior research has shown that patients are interested in engaging more in safety efforts [31][32][33] and that physicians, nurses, and other health care professionals support increasing such patient involvement. 31,32 However, interpersonal, intrapersonal, and cultural barriers to patient involvement in safety initiatives exist.…”

“…31,32 However, interpersonal, intrapersonal, and cultural barriers to patient involvement in safety initiatives exist. 34 For instance, patients appear to be less comfortable with safety efforts that require them to engage in what they perceive as challenging behaviors (eg, notifying physicians/nurses of errors) and conversely more comfortable with efforts that involve non challenging behaviors (eg, reporting an error to a reporting system).…”

Patient engagement with infection management in secondary care: a qualitative investigation of current experiences

“…Despite a paucity of evidence to support patient focused interventions within AMS programmes, a growing body of literature is emerging that describes physician's and patient's desire for increased collaboration in the decision-making process surrounding the prescription of medications within secondary care 21. However, there is currently no specific evidence describing patients’ experiences of infection management and antimicrobial prescribing within this setting.…”