JMIR Publications

ABSTRACT

Background:

Harm from medications is a major patient safety challenge among older persons. Adverse drug events tend to arise when prescribing or evaluating medications; therefore, interventions targeting these may promote patient safety. Guidelines highlight the value of a joint plan for continued treatment. If such a plan includes medications, a medication plan, patient safety may be improved. There is growing evidence for the benefits of inviting actors in healthcare to improve healthcare products and services by co-design.

Objective:

To characterize a co-designed medication plan and to explore participants’ reasoning about different design choices.

Methods:

With a case study design, we collected and analyzed qualitative and quantitative data and compared them side-by-side in the discussion. We explored needs and requirements of a medication plan, expressed by 14 participants (older persons, nurses and physicians) during a co-design initiative in one regional health system in Sweden. Directed content analysis was performed of qualitative data gathered from Workshops, and of free-text responses from a survey and interviews. Descriptive statistics were used to analyze the quantitative data from survey answers.

Results:

A medication plan must provide an added everyday value related to safety, effort and engagement. The physicians addressed challenges in setting aside time for the task, and the older persons raised the potential for increased patient involvement. According to the participants’ a medication plan should support communication, continuity and interaction. The nurses specifically addressed need for a plan that was easy to overview. Important function requirements were to provide instant access, automation and attention. Content requirements were related to detailed information about the medication treatment. Having the plan linked to the medication list and instantly obtainable information was addressed more over time.

Conclusions:

After reasoning about needs and requirements for a medication plan, the participants agreed on a medication plan linked to the medication list within the existing electronic health record. They stated that a medication plan should support communication, continuity and interaction, with information that is adequate and adapted for everyone, as well as easy to access and overview. According to the participants, the medication plan prototype had the potential to promote patient safety and enable patient engagement, but concerns were raised related to its use in daily clinical practice. The last step in the co-design framework is about testing the intervention to explore how it works and connects users. Therefore, testing the medication plan prototype in clinical practice would be a future step. Clinical Trial: Not applicable