RT Journal Article
SR Electronic
T1 The Patient-Held Active Record of Medication Status (PHARMS) study: a mixed-methods feasibility analysis
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e345
OP e355
DO 10.3399/bjgp19X702413
VO 69
IS 682
A1 Elaine K Walsh
A1 Laura J Sahm
A1 Colin P Bradley
A1 Kieran Dalton
A1 Kathleen O’Sullivan
A1 Stephen McCarthy
A1 Eimear Connolly
A1 Ciara Fitzgerald
A1 William H Smithson
A1 David Kerins
A1 Derina Byrne
A1 Patricia M Kearney
YR 2019
UL http://bjgp.org/content/69/682/e345.abstract
AB 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.