JMIR Publications

ABSTRACT

Background:

Harm from medications is a major patient safety challenge. Most adverse drug events arise when a medication is prescribed or re-evaluated. Therefore, interventions in this area may improve patient safety. A medication plan, i.e. a plan for continued treatment with medications, may support patient safety. Patients’ participation in the (re-)design of healthcare products or services may improve patient safety. An approach that emphasises patient involvement is co-design, such as the Double Diamond from the Design Council, England. As the Covid-19 pandemic brought restrictions to face-to-face co-design approaches, the interest in remote approaches increased. Yet, it has been uncertain how best to perform remote co-design. We therefore explored a remote approach, which brought together older persons and healthcare professionals to co-designing a joint medication plan aimed at improving patient safety.

Objective:

This study aims to describe how remote co-design was applied to create a medication plan prototype, and to explore experiences of this approach.

Methods:

Within a case study design, we explored experiences of the remote co-design initiative with 14 participants. A thematic analysis of qualitative data gathered from workshops, interviews and free-text responses to survey questions was performed. Using descriptive statistics, quantitative data from questionnaires and online workshop time-stamps were analysed. Qualitative and quantitative data were compared side-by-side in the discussion.

Results:

Time-deviation for each activity in the workshops showed that the background, introduction to and test of a digital notebook took longer than planned. Questionnaires revealed that participants assessed workshops as good. The thematic analysis yielded the following main themes: Everyone’s perspective matters, Learning by sharing, and Mastering a digital space. The themes encompass what helped to establish a permissive climate that allowed the participants to be involved and share viewpoints. There was a dynamic process of learning and understanding, realising that despite different backgrounds, there was consensus about requirements for a medication plan. The remote co-design process seemed appealing, by balancing opportunities and challenges, and building an inviting, creative and tolerant climate.

Conclusions:

The remote co-design initiative, aiming to create a medication plan prototype, was experienced to be inclusive of the participants’ perspectives and to create learning by sharing experiences. The Double Diamond framework was applicable in a digital context and supported the co-design process. Remote co-design is still novel, but with attentiveness to power relations between all involved, this approach may increase opportunities for older persons and healthcare professionals to collaboratively design products or services that can improve patient safety. Clinical Trial: Not applicable