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Wang Y, Wong ELY, Qiu H, Cheung AWL, Tang KS, Yeoh EK. The influence of written medication reminder on patient experience among older adult patients: a repeat cross-sectional study. BMC Geriatr 2024; 24:662. [PMID: 39112924 PMCID: PMC11304567 DOI: 10.1186/s12877-024-05253-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/26/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND Older adult patients are particularly vulnerable to medication-related issues during the discharge process. To enhance medication discharge education and patient experience, a written medication reminder, incorporating crucial medication side effects and warning signs, was implemented in medicine wards. This study aimed to examine the influence of this reminder on patient experience and medication-taking behaviors among older adults in public healthcare settings. METHODS Two separate rounds of cross-sectional surveys were conducted before and after the program implementation among different discharged patients in each round. The study enrolled older adult patients aged ≥ 65 or their caregivers discharged from the medical wards of four pilot public hospitals in Hong Kong. A structured questionnaire was administered via telephone within 14 days of the patient's discharge. The survey assessed patients' experience with the provided medication information during discharge, including the clarity, adequacy, and usefulness of the information, as well as their overall experience with inpatient services. The self-reported medication-taken behaviors, including adherence and side-effect encounters, were also measured. RESULTS A total of 1,265 responses were collected before the implementation of the medication reminder, and 1,426 responses were obtained after the implementation. Pre/post-implementation survey comparison showed significant improvement in patient experience regarding the clarity of the provided medication information (7.93 ± 1.84 vs. 8.18 ± 1.69, P = 0.002), adequacy (7.92 ± 1.93 vs. 8.15 ± 1.76, P = 0.014), and usefulness (8.06 ± 1.80 vs. 8.26 ± 1.70, P = 0.017), significantly positive experience on the overall discharge information (β coefficient, 0.43 [95%CI, 0.30 to 0.56]) and inpatient service (β coefficient, 0.47 [95%CI, 0.32 to 0.61]). In addition, the side effects encounters were significantly lower in the post-implementation survey group (11.6% vs. 9.0%, P = 0.04) and no statistical difference was found in self-reported medication adherence between the two groups. CONCLUSIONS The provision of written medication reminders on key medication risks effectively improved older adult patients' experience and reduced side effects without any unintended negative consequences. The findings can serve as a reference for similar settings seeking to enhance post-discharge care among older adult patients. Future studies could investigate the influence in other specialties and age groups and include clinical outcomes to test the program's effectiveness.
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Affiliation(s)
- Yingxuan Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eliza Lai-Yi Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Hong Qiu
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Annie Wai-Ling Cheung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Eng-Kiong Yeoh
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Wang DY, Wong ELY, Cheung AWL, Tam ZPY, Tang KS, Yeoh EK. Implementing the information system for older adult patients post-discharge self-management: a qualitative study. Age Ageing 2024; 53:afae136. [PMID: 38970302 PMCID: PMC11225609 DOI: 10.1093/ageing/afae136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 05/02/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND Discharging older adult patients from the hospital poses risks due to their vulnerable conditions, complex instructions and limited health literacy. Insufficient information about medication side effects adds to patient concerns. To address this, a post-discharge information summary system was developed. While it has shown positive impacts, concerns exist regarding implementation fidelity. OBJECTIVE This study employed a theory-driven approach to understand health providers' perspectives on effective implementation. METHOD Individual semi-structured interviews were conducted via telephone with nurses, doctors and pharmacists from local public hospitals. All interviews were audio-recorded and transcribed verbatim. Theoretical Domains Framework (TDF) was applied for direct content analysis. Belief statements were generated by thematic synthesis under each of the TDF domains. RESULTS A total of 98 participants were interviewed. Out of the 49 belief statements covering eight TDF domains, 19 were determined to be highly relevant to the implementation of the post-discharge information summary system. These TDF domains include knowledge, skills, social/professional role and identity, beliefs about consequences, intentions, memory, attention and decision processes, environmental context and resources and social influences. CONCLUSION Our study contributes to the understanding of determinants in implementing discharge interventions for older adult patients' self-care. Our findings can inform tailored strategies for frontline staff, including aligning programme rationale with stakeholders, promoting staff engagement through co-creation, reinforcing positive programme outcomes and creating default settings. Future research should employ rigorous quantitative designs to examine the actual impact and relationships among these determinants.
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Affiliation(s)
- Dorothy Yingxuan Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eliza Lai-Yi Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Annie Wai-Ling Cheung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zoe Pui-Yee Tam
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kam-Shing Tang
- Kwong Wah Hospital, Hospital Authority, Hong Kong SAR, China
| | - Eng-Kiong Yeoh
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Taylor JG, Ayosanmi S, Sansgiry SS. Consumer Impressions of the Safety and Effectiveness of OTC Medicines. PHARMACY 2023; 11:pharmacy11020051. [PMID: 36961029 PMCID: PMC10037583 DOI: 10.3390/pharmacy11020051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
The public generally believes OTC medicines to be helpful for treating minor ailments. From a survey point of view, that position often originates from feedback obtained when these medicines are considered as one broad category. The objective of the study was to assess the properties of 15 categories of agents across three dimensions-effectiveness, safety, and familiarity. Data were gathered via an online non-random survey in one Canadian province, where residents were asked to consider 15 OTC medicine categories in terms of those dimensions. Five hundred and seventy-five completed surveys were obtained out of 3000 sent. On the 10-point effectiveness scale, values ranged from 5.1 (Athlete's foot cream) to 7.3 (headache medicine). For safety, the medicines were closely grouped (6.0 to 7.4). Cough syrups for children were perceived as less safe than those for adults. There was a trend in that, as product familiarity grew, so did impressions of safety and effectiveness. The results support other reports where OTC medicines are described as safe and effective, although safety ratings were not particularly high. Responders considered these medicines to generally be higher in safety than effectiveness.
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Affiliation(s)
- Jeffrey Gordon Taylor
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Stephen Ayosanmi
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Sujit S Sansgiry
- College of Pharmacy, University of Houston, Houston, TX 77204, USA
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Ge P, Zhang ZW, Zhang JZ, Lyu K, Niu YY, Tong YT, Xiong P, Ling R, Li QY, Yu WL, Min HW, Deng YQ, Wang YJ, Sun XN, Sun XY, Yu L, Wu YB. The self-medication behaviors of residents and the factors related to the consideration of drug efficacy and safety-A cross-sectional study in China. Front Pharmacol 2023; 14:1072917. [PMID: 36925637 PMCID: PMC10011170 DOI: 10.3389/fphar.2023.1072917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/17/2023] [Indexed: 03/08/2023] Open
Abstract
Background: Over-the-counter (OTC) drugs facilitates residents self-medication. However, inappropriate self-medications have become a serious problem in China and even all over the world. Objectives: To make an investigation on the current status of Chinese residents' self-medication behaviors and important considerations, and to explore the factors related to the considerations of drug efficacy and safety. Design: A quantitative, cross-sectional study. Methods: Multi-stage sampling was used to conduct a cross-sectional investigation in China 22 provinces, 5 autonomous regions and 4 municipalities directly under the Central Government. State that an interviewer-administrated questionnaire, was used for data collection. The questionnaire that was used in the investigation included demographic sociological characteristics, health literacy scale-short form (HLS-SF), the 10-item Big Five Inventory (BFI-10), the EuroQol-5D visual analogue scale (EQ-5D VAS), self-medication status and important considerations when self-medicating. Descriptive statistics were performed, and the Chi-square test was used for univariate analysis. Log-binomial regression was used for multivariate analysis on whether residents regard drug efficacy or safety as an important consideration. Results: 9256 respondents were included in the data analysis. The self-medication rate of Chinese adults was as high as 99.1%. Paracetamol and other analgesics were the most common types of OTC medication that respondents purchased, followed by vitamins/minerals. Medical staff recommendations, drug safety and efficacy were the top three important considerations. The residents in the east, central and western regions who consider safety is 63.5%, 61.5%, and 66.8% respectively. The proportion of curative effect was 60.2%, 55.7%, and 61.4% respectively. Log-binomial regression showed that western respondents, retired people, those who mainly used ways including basic medical insurance for employees, commercial medical insurance, free medical treatment to cover their medical cost, respondents with high neuroticism, high health literacy were more likely to consider drug safety as an important factor (p < 0.05). Eastern respondents, employed, main way of medical expenses borne was Out-of-pocket Payment, those with chronic disease were more likely to consider drug efficacy as an important factor (p < 0.05). Female, respondents with high levels of agreeableness, conscientiousness, openness, and self-rated health status were more likely to regard both drug safety and efficacy as important considerations (p < 0.05). Conclusion: Self-medication is practiced by most Chinese adults. Whether Chinese adults take drug efficacy or safety as an important consideration is related to their demographic and sociological characteristics, Big Five personality characteristics, health literacy and self-assessed health status. There is a need to strengthen the management of OTC drugs and public education about self-medication.
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Affiliation(s)
- Pu Ge
- Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Zi-Wei Zhang
- School of Public Health, Peking University, Beijing, China
| | - Jin-Zi Zhang
- School of Humanities and Social Sciences, Harbin Medical University, Harbin, China
| | - Ke Lyu
- China Medical University, Liaoning, China
| | - Yu-Yao Niu
- Department of English, Faculty of Arts and Humanities, University of Macau, Macao, China
| | - Yu-Ting Tong
- School of Public Health, Shandong University, Jinan, China
| | - Ping Xiong
- Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Rong Ling
- Jilin University School of Pharmaceutical Sciences, Jilin University, Changchun, China
| | - Qi-Yu Li
- School of Humanities and management, Jinzhou Medical University, Jinzhou, China
| | - Wen-Li Yu
- School of Foreign Languages, Weifang University of Science and Technology, Weifang, China
| | - He-Wei Min
- School of Public Health, Peking University, Beijing, China
| | - Yu-Qian Deng
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yu-Jia Wang
- School of Humanities and Social Sciences, Harbin Medical University, Harbin, China
| | - Xiao-Nan Sun
- School of Humanities and Social Sciences, Harbin Medical University, Harbin, China
| | - Xin-Ying Sun
- School of Public Health, Peking University, Beijing, China
| | - Lian Yu
- Health Care system Reform and Development Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Yi-Bo Wu
- School of Public Health, Peking University, Beijing, China
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Cox AR, Wilkins SJ, Routledge PA. How do pharmacists contribute to global medication safety? INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2020; 28:549-551. [DOI: 10.1111/ijpp.12676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Anthony R Cox
- School of Pharmacy, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Simon J Wilkins
- Pharmacology, Therapeutics and Toxicology, School of Medicine, Cardiff University, Heath Park, Cardiff, UK
| | - Philip A Routledge
- Pharmacology, Therapeutics and Toxicology, School of Medicine, Cardiff University, Heath Park, Cardiff, UK
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