JMIR Publications

ABSTRACT

Background:

Innovation in technology and automation has been increasingly used to improve conventional medication management process. In Hong Kong, the current practices of medication management in old age homes (OAHs) are time consuming, labor intensive and error prone.

Objective:

This pilot study compared the time efficiency, reduction in mediation errors and medication wastage in OAHs before and at least 2 weeks after the implementation of a medication management program combining information technology (IT), automation technology (AT) and the Internet of Things (IoT).

Methods:

From November 2019 to February 2020, we recruited two OAHs (serving 178 residents) in Hong Kong into the prospective, pre-post interventional study. The program consisted of electronic medication profiles, automated packaging and electronic records of medication administration. Using three-way analysis of variance (ANOVA), we compared the number of doses prepared and checked in 10-minute blocks before and after implementation. We received anonymous reports of medication errors from OAH staff and analyzed the results with Fisher’s exact test. We also calculated the quantity and cost of wasted medications from drug disposal reports.

Results:

The number of doses prepared and checked in 10-minute blocks significantly increased post-implementation (pre: 41.3 (standard deviation (SD): 31.8); post: 70.6 (SD: 22.8); p< .001). There was also a significant reduction in medication errors (pre: 10/9,504 doses [0.1%]; post: 0/5,731 doses; p= .017). The total cost of wasted medications during January 2020 in OAH 1 (77 residents) and OAH 2 (101 residents) was HK$2,566.03 (US$328.98) and HK$5,249.48 (US$673.01), respectively.

Conclusions:

Our pilot study suggested that an innovative medication management program with IT, AT and IoT components improved the time efficiency of medication preparation and medication safety for OAHs. It is a promising solution to address the current limitations in medication management in OAHs in Hong Kong.