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Evaluation of Patient and Family Engagement Strategies to Improve Medication Safety

Author

Listed:
  • Julia M. Kim

    (Johns Hopkins University)

  • Catalina Suarez-Cuervo

    (Johns Hopkins University)

  • Zackary Berger

    (Johns Hopkins University)

  • Joy Lee

    (Johns Hopkins University)

  • Jessica Gayleard

    (Johns Hopkins University)

  • Carol Rosenberg

    (Johns Hopkins University)

  • Natalia Nagy

    (Johns Hopkins University)

  • Kristina Weeks

    (Johns Hopkins University)

  • Sydney Dy

    (Johns Hopkins University)

Abstract

Background Patient and family engagement (PFE) is critical for patient safety. We systematically reviewed types of PFE strategies implemented and their impact on medication safety. Methods We searched MEDLINE, EMBASE, reference lists and websites to August 2016. Two investigators independently reviewed all abstracts and articles, and articles were additionally reviewed by two senior investigators for selection. One investigator abstracted data and two investigators reviewed the data for accuracy. Study quality was determined by consensus. Investigators developed a framework for defining the level of patient engagement: informing patients about medications (Level 1), informing about engagement with health care providers (Level 2), empowering patients with communication tools and skills (Level 3), partnering with patients in their care (Level 4), and integrating patients as full care team members (Level 5). Results We included 19 studies that mostly targeted older adults taking multiple medications. The median level of engagement was 2, ranging from 2–4. We identified no level 5 studies. Key themes for patient engagement strategies impacting medication safety were patient education and medication reconciliation, with a subtheme of patient portals. Most studies (84%) reported implementation outcomes. The most commonly reported medication safety outcomes were medication errors, including near misses and discrepancies (47%), and medication safety knowledge (37%). Most studies (63%) were of medium to low quality, and risk of bias was generally moderate. Among the 11 studies with control groups, 55% (n = 6) reported statistically significant improvement on at least one medication safety outcome. Further synthesis of medication safety measures was limited due to intervention and outcome heterogeneity. Conclusions Key strategies for engaging patients in medication safety are education and medication reconciliation. Patient engagement levels were generally low, as defined by a novel framework for determining levels of patient engagement. As more patient engagement studies are conducted, this framework should be evaluated for associations with patient outcomes.

Suggested Citation

  • Julia M. Kim & Catalina Suarez-Cuervo & Zackary Berger & Joy Lee & Jessica Gayleard & Carol Rosenberg & Natalia Nagy & Kristina Weeks & Sydney Dy, 2018. "Evaluation of Patient and Family Engagement Strategies to Improve Medication Safety," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 11(2), pages 193-206, April.
  • Handle: RePEc:spr:patien:v:11:y:2018:i:2:d:10.1007_s40271-017-0270-8
    DOI: 10.1007/s40271-017-0270-8
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    References listed on IDEAS

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    1. Doherty, Carole & Stavropoulou, Charitini, 2012. "Patients' willingness and ability to participate actively in the reduction of clinical errors: A systematic literature review," Social Science & Medicine, Elsevier, vol. 75(2), pages 257-263.
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    Cited by:

    1. Mojtaba Vaismoradi & Susanna Tella & Patricia A. Logan & Jayden Khakurel & Flores Vizcaya-Moreno, 2020. "Nurses’ Adherence to Patient Safety Principles: A Systematic Review," IJERPH, MDPI, vol. 17(6), pages 1-15, March.
    2. Tiina Syyrilä & Katri Vehviläinen‐Julkunen & Marja Härkänen, 2020. "Communication issues contributing to medication incidents: Mixed‐method analysis of hospitals’ incident reports using indicator phrases based on literature," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(13-14), pages 2466-2481, July.
    3. Modigh, Anton & Sampaio, Filipa & Moberg, Linda & Fredriksson, Mio, 2021. "The impact of patient and public involvement in health research versus healthcare: A scoping review of reviews," Health Policy, Elsevier, vol. 125(9), pages 1208-1221.
    4. Amber Damiaens & Ann Van Hecke & Veerle Foulon, 2023. "Medication Decision-Making and the Medicines’ Pathway in Nursing Homes: Experiences and Expectations of Involvement of Residents and Informal Caregivers," IJERPH, MDPI, vol. 20(11), pages 1-13, May.

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