The Patient-Held Active Record of Medication Status (PHARMS) study: A mixed-methods feasibility analysis
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Date
2019-05-01
Authors
Walsh, Elaine K.
Sahm, Laura J.
Bradley, Colin P.
Dalton, Kieran
O'Sullivan, Kathleen
McCarthy, Stephen
Connolly, Eimear
Fitzgerald, Ciara
Smithson, William H.
Kerins, David
Journal Title
Journal ISSN
Volume Title
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Published Version
Abstract
Background: Medication errors frequently occur as patients transition between hospital and the community, and may result in patient harm. Novel methods are required to address this issue. Aim: To assess the feasibility of introducing an electronic patient-held active record of medication status device (PHARMS) at the primary-secondary care interface at the time of hospital discharge. Design and setting: A mixed-methods study (non-randomised controlled intervention, and a process evaluation of qualitative interviews and non-participant observation) among patients >60 years in an urban hospital and general practices in Cork, Ireland. Method: The number and clinical significance of errors were compared between discharge prescriptions of the intervention (issued with a PHARMS device) and control (usual care, handwritten discharge prescription) groups. Semi-structured interviews were conducted with patients, junior doctors, GPs, and IT professionals, in addition to direct observation of the implementation process. Results: In all, 102 patients were included in the final analysis (intervention n = 41, control n = 61). Total error number was lower in the intervention group (median 1, interquartile range [IQR] 0-3) than in the control group (median 8, IQR (4-13.5, P<0.001), with the clinical significance score in the intervention group also being lower than the control group (median 2, IQR 0-4 versus median 11, IQR 5-20, P<0.001). The PHARMS device was found to be technically implementable using existing information technology infrastructure, and acceptable to all key stakeholders. Conclusion: The results suggest that using PHARMS devices within existing systems in general practice and hospitals is feasible and acceptable to both patients and doctors, and may reduce medication error.
Description
© 2019 British Journal of General Practice.
Keywords
Electronic health records , General practice , Medication errors , Patient transfer , Secondary care , [Pharmacy] , [Medicine] , [Insight Centre for Data Analytics] , [CUBS] , Family Practice
Citation
Walsh, E K, Sahm, L J, Bradley, C P, Dalton, K, O'Sullivan, K, McCarthy, S, Connolly, E, Fitzgerald, C, Smithson, W H, Kerins, D, Byrne, D & Kearney, P M 2019, 'The Patient-Held Active Record of Medication Status (PHARMS) study: A mixed-methods feasibility analysis', British Journal of General Practice, vol. 69, no. 682, pp. 345-355. https://doi.org/10.3399/bjgp19X702413
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