Abstract
Background
Increasing age is associated with more medication errors in hospitalised patients. Patient engagement is a strategy to reduce medication harm.
Aims
To measure older patients’ preferences for and reported medication safety behaviours, identify the relationship between preferred and reported medication safety behaviours and identify whether perceptions of medication safety behaviours differ between groups of young–old, middle–old and old–old patients (65–74 years, 75–84 years, and ≥ 85 years).
Methods
A survey, which included the Inpatient Medication Safety Involvement Scale (IMSIS) was administered to 200 older patients from medical settings, at one hospital. Data were analysed using descriptive statistics, Spearman’s rho and the Kruskal–Wallis test.
Results
Patients reported a desire to ask questions (59.5% n = 119) and check with healthcare professionals if they perceived that a medication was wrong (86.5% n = 173) or forgotten (87.0% n = 174). Patients did not have particular preferences, which differed from their experiences in terms of viewing the medication administration chart and self-administering medications. Preferred and reported behaviours correlated positively (r = 0.46–0.58, n = 200, p ≤ 0.001). Young-old patients preferred notifying healthcare professionals of perceived medication errors more than middle–old and old–old patients (p ≤ 0.05).
Conclusions
Older patients may prefer verbal medication safety behaviours like asking questions and notifying healthcare professionals of medication errors, over viewing medication charts and self-administering medications. The young-old group wanted to identify perceived medication errors more than other age groups. Older patients are willing to engage in medication safety behaviours, and healthcare professionals and organisations need to embrace this engagement in an effort to reduce medication harm.
Similar content being viewed by others
References
Nguyen T-L, Leguelinel-Blache G, Kinowski J-M et al (2017) Improving medication safety: development and impact of a multivariate model-based strategy to target high-risk patients. PLoS ONE 12:e1–e13. https://doi.org/10.1371/journal.pone.0171995
Picone DM, Titler MG, Dochterman J et al (2008) Predictors of medication errors among elderly hospitalized patients. Am J Med Qual 23:115–127. https://doi.org/10.1177/1062860607313143
World Health Organisation (2019) Medication safety in high-risk situations. https://apps.who.int/iris/bitstream/handle/10665/325131/WHO-UHC-SDS-2019.10-eng.pdf?ua=1.
World Health Organisation (2017) Medication without harm. http://apps.who.int/iris/bitstream/10665/255263/1/WHO-HIS-SDS-2017.6-eng.pdf?ua=1&ua=1. Accessed 11 Nov 2018
Canadian Patient Safety Institute (2017) Medication safety. http://www.patientsafetyinstitute.ca/en/Topic/Pages/Medication-Safety.aspx Accessed 1 Nov 2018
Wang S-Y, Zhao Y, Zang X-Y (2014) Continuing care for older patients during the transitional period. Chin Nurs Res 1:5–13. https://doi.org/10.1016/j.cnre.2014.11.001
Kim JM, Suarez-Cuervo C, Berger Z et al (2017) Evaluation of patient and family engagement strategies to improve medication safety. Patient 11:193–206. https://doi.org/10.1007/s40271-017-0270-8
Higgins T, Larson E, Schnall R (2016) Unraveling the meaning of patient engagement: a concept analysis. Patient Educ Couns 100:30–36. https://doi.org/10.1016/j.pec.2016.09.002
Menichetti J, Libreri C, Lozza E et al (2016) Giving patients a starring role in their own care: a bibliometric analysis of the on-going literature debate. Health Expect 19:516–526. https://doi.org/10.1111/hex.12299
Mohsin-Shaikh S, GarfieldFranklin SBD (2014) Patient involvement in medication safety in hospital: an exploratory study. Int J Clin Pharm 36:657–666. https://doi.org/10.1007/s11096-014-9951-8
Tobiano G, Chaboyer W, Teasdale T et al (2020) Older patient and family discharge medication communication: a mixed-methods study. J Eval Clin Pract. https://doi.org/10.1111/jep.13494
Harris PA, Taylor R, Thielke R et al (2009) Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42:377–381. https://doi.org/10.1016/j.jbi.2008.08.010
IBM Corp (2019) IBM SPSS Statistics for Windows, Version 26.0. 2019, NY: IBM Corp
Pallant J (2016) SPSS survival manual: a step by step guide to data analysis using IBM SPSS, 6th edn. Allen & Unwin, Sydney
Gilford DM (1988) The aging population in the twenty-first century: statistics for health policy. https://www.ncbi.nlm.nih.gov/books/NBK217732/ Accessed 12 Jun 2020
Katz MG, Jacobson TA, Veledar E et al (2007) Patient literacy and question-asking behavior during the medical encounter: a mixed-methods analysis. J Gen Intern Med 22:782–786. https://doi.org/10.1007/s11606-007-0184-6
Nyborg I, Kvigne K, Danbolt LJ et al (2016) Ambiguous participation in older hospitalized patients: gaining influence through active and passive approaches-a qualitative study. BMC Nurs 15:e1–e11. https://doi.org/10.1186/s12912-016-0171-5
Vaismoradi M, Jordan S, Kangasniemi M (2015) Patient participation in patient safety and nursing input—a systematic review. J Clin Nurs 24:627–639. https://doi.org/10.1111/jocn.12664
Garfield S, Jheeta S, Husson F et al (2016) The role of hospital inpatients in supporting medication safety: a qualitative study. PLoS ONE 11:e1–e17. https://doi.org/10.1371/journal.pone.0153721
Manias E, Beanland C, Riley R et al (2004) Self-administration of medication in hospital: patients’ perspectives. J Adv Nurs 46:194–203. https://doi.org/10.1111/j.1365-2648.2003.02979.x
Vanwesemael T, Boussery K, Manias E et al (2018) Self-management of medication during hospitalisation: healthcare providers’ and patients’ perspectives. J Clin Nurs 27:753–768. https://doi.org/10.1111/jocn.14084
Anderson J, Manias E, Kusljic S et al (2014) Testing the validity, reliability and utility of the self-administration of medication (SAM) tool in patients undergoing rehabilitation. Res Social Adm Pharm 10:204–216. https://doi.org/10.1016/j.sapharm.2013.04.013
Manias E, Bucknall T, Wickramasinghe N et al (2020) Patient and family engagement in communicating with electronic medical records in hospitals: a systematic review. Int J Med Inform 134:e1–e15. https://doi.org/10.1016/j.ijmedinf.2019.104036
Irizarry T, DeVito Dabbs A, Curran CR (2015) Patient portals and patient engagement: a state of the science review. J Med Internet Res 17:e148–e169. https://doi.org/10.2196/jmir.4255
Hambleton SJ, Aloizos AJ (2019) Australia’s digital health journey. Med J Aust 210:e5–e6. https://doi.org/10.5694/mja2.50039
Otte-Trojel ET, Bont A, Rundall T et al (2016) What do we know about developing patient portals? A systematic literature review. J Am Med Inf Assoc JAMIA 23:e162–e168. https://doi.org/10.1093/jamia/ocv114
de Jong CC, Ros WJG, van Leeuwen M et al (2016) Exploring the effects of patients taking a vigilant role in collaborating on their e-medication administration record. Int J Med Inf 88:18–24. https://doi.org/10.1016/j.ijmedinf.2016.01.001
Osborn CY, Mayberry LS, Wallston KA et al (2013) Understanding patient portal use: implications for medication management. J Med Internet Res 15:204–215. https://doi.org/10.2196/jmir.2589
Hoogland AI, Mansfield J, Lafranchise EA et al (2020) eHealth literacy in older adults with cancer. J Geriatr Oncol 11:1020–1022. https://doi.org/10.1016/j.jgo.2019.12.015
Sakaguchi-Tang DK, Bosold AL, Choi YK et al (2017) Patient portal use and experience among older adults: systematic review. JMIR Med Inform 5:e38–e38. https://doi.org/10.2196/medinform.8092
Jerofke-Owen TD, Ahlman J (2019) Patients’ perspectives on engaging in their healthcare while hospitalised. J Clin Nurs 28:340–350. https://doi.org/10.1111/jocn.14639
Chen K-M, Lin M-H, Wang Y-C et al (2013) Psychological and socioeconomic health of community-dwelling older adults. Int J Psychol 48:1038–1049. https://doi.org/10.1080/00207594.2013.771814
Davis R, Briggs M, Arora S et al (2014) Predictors of health care professionals’ attitudes towards involvement in safety-relevant behaviours. J Eval Clin Pract 20:12–19. https://doi.org/10.1111/jep.12073
Foss C (2011) Elders and patient participation revisited—a discourse analytic approach to older persons’ reflections on patient participation. J Clin Nurs 20:2014–2022. https://doi.org/10.1111/j.1365-2702.2010.03505.x
Tobiano G, Chaboyer W, Teasdale T et al (2019) Patient engagement in admission and discharge medication communication: a systematic mixed studies review. Int J Nurs Stud 95:87–102. https://doi.org/10.1016/j.ijnurstu.2019.04.009
Lingaratnam S, Aranda S, Pearce T et al (2012) A controlled before and after study to evaluate a patient and health professional partnership model towards effective medication reconciliation. J Oncol Pharm Pract 19:48–56. https://doi.org/10.1177/1078155212451936
Ozavci G, Bucknall T, Woodward-Kron R et al (2020) A systematic review of older patients’ experiences and perceptions of communication about managing medication across transitions of care. Res Social Adm Pharm 17:273–291. https://doi.org/10.1016/j.sapharm.2020.03.023
Hirpa M, Woreta T, Addis H et al (2020) What matters to patients? A timely question for value-based care. PLoS ONE 15:e0227845. https://doi.org/10.1371/journal.pone.0227845
Pimentel CB, Snow AL, Carnes SL et al (2021) Huddles and their effectiveness at the frontlines of clinical care: a scoping review. J Gen Intern Med. https://doi.org/10.1007/s11606-021-06632-9
Backman C, Cho-Young D (2019) Engaging patients and informal caregivers to improve safety and facilitate person- and family-centered care during transitions from hospital to home—a qualitative descriptive study. Patient Prefer Adherence 13:617–626. https://doi.org/10.2147/PPA.S201054
Manias E, Watson B (2014) Moving from rhetoric to reality: patient and family involvement in bedside handover. Int J Nurs Stud 51:1539–1541. https://doi.org/10.1016/j.ijnurstu.2014.08.004
Van Grootven B, Flamaing J, De Casterlé BD et al (2017) Effectiveness of in-hospital geriatric co-management: a systematic review and meta-analysis. Age Ageing 46:903–910. https://doi.org/10.1093/ageing/afx051
Leguelinel-Blache G, Castelli C, Rolain J et al (2020) Impact of pharmacist-led multidisciplinary medication review on the safety and medication cost of the elderly people living in a nursing home: a before-after study. Expert Rev Pharmacoecon Outcomes Res 20:481–490. https://doi.org/10.1080/14737167.2020.1707082
Bowling A (2005) Mode of questionnaire administration can have serious effects on data quality. J Public Health (Oxf) 27:281–291. https://doi.org/10.1093/pubmed/fdi031
Jerofke-Owen TA, Garnier-Villarreal M (2020) Development and psychometric analysis of the patient preferences for engagement tool. Nurs Res 69:289–298. https://doi.org/10.1097/NNR.0000000000000423
Funding
This study was funded by the Gold Coast Hospital and Health Service and Gold Coast Hospital Foundation Research Grant Scheme 2018. Grant ID: RGS201800001.
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by GT, WC, GD and EM. The first draft of the manuscript was written by GT and all authors commented on subsequent versions of the manuscript. All authors read and approved the final manuscript. We would like to thank Professor Lukman Thalib and Dr. Jeremy Wellwood for their input during study conception, design and data collection.
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflicts of interest to declare that are relevant to the content of this article.
Availability of data and material
The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
Ethical approval
This study was approved by the appropriate institutional and/or national research ethics committee including Gold Coast Hospital and Health Service Human Research Ethics Committee, Deakin University Human Research Ethics Committee and Griffith University Human Research Ethics Committee. This study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Tobiano, G., Chaboyer, W., Dornan, G. et al. Older patients’ engagement in hospital medication safety behaviours. Aging Clin Exp Res 33, 3353–3361 (2021). https://doi.org/10.1007/s40520-021-01866-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40520-021-01866-3