The patient-public-led development of a

“Medication Passport‟

Kandarp ThakkarLead Pharmacist – Admissions

Project Manager

Saadia JamilSenior Pharmacist – Admissions

Project Support

Making Healthcare Safer

28th June 2011

Overview• ImPE Project• Patient Public Involvement• Medication Passport• Workshop• Summary

• To develop a medication review system based on an evidence based tool (“STOPP” – Screening Tool of Older Persons potentially inappropriate Prescriptions) for use with elderly patients across all sectors and interfaces of care

• And providing patients with better information about their medicines

Improving Prescribing in the Elderly (ImPE Project)

Aims

CLAHRC

• Collaboration for Leadership in Applied Health Research & Care

• 9 CLAHRC’s – each £10m over 5 years –NIHR funded and managed

• Focus - Cooksey’s "second gap in translation“ (Review of Health Research)

• Main aim - to support the translation of research evidence into practice in the NHS

• Quality Improvement Methodology• Process mapping• Action Effect diagram• Plan Do Study Act (PDSA) cycles

• Sustainability assessments and action

• Strong Patient and Public Involvement (PPI)

Standard NHS approach to quality improvement

Patient Public Involvement

• To explore what sort of information patients need about medicines

• To take part in the creation of different modes of getting this information

• To ensure understanding of patients using surveys and interviews

Medication passport idea originated from focus group

Discussed with multiprofessional project team including patient representation

A mock-up of the passport was taken to a reader group

Passport was redesigned based on comments from reader group

This was taken to a further reader group and external organisations for comments

Ratified by project team

lack of staff continuity which hinders effective communication

Who is responsible for my medication

changes?

Not being told why they are changing

my medication

uncertainty about who is responsible/ liable for communicating these

changes

Lack of information

about the new medicine

Medication Passport – evaluation

• Evaluation currently underway• Quantitative surveys and

qualitative interviews / videos• Further focus group planned

Results – Survey of Medicines Passport users

Overwhelming agreement/satisfaction with . . .

Function• To carry around and show anyone involved with patient care• To ensure transfer of info between different sectors of care• To ensure transfer of info between the healthcare team in hospital• To ensure transfer of info between the community healthcare team

Presentation• Text, colour, layout, • Ease of understanding, completion

Usefulness • Recommend to family/friend/HCP

http://www.partnershipforhealth.org.uk/

Workshop• Split into 4 groups

Challenges with PPI• Recruitment

– What best fits team and project

• Project team meetings– Effective chairing– Communication – Hidden Agenda

• Getting the most relevant points• Language barrier• Complaints – ‘buddy’ system• Logistics – Contract, CRB etc.

How do you engage patients?• ‘Expert’ patient(s) on project steering group• Focus groups• Reader groups• Public facing national organisations e.g. Age UK• Local organisations e.g. LINKS, Hestia• Patients from other projects• ‘Real’ patients i.e. inpatients

Benefits of PPI and how to harness

• The patient perspective• Attention to detail we would ignore• Using patients as service users in design vs

comments after design• Use a range of PPI involvement methods

Using patients in evaluation

• Surveys – involving patients in design

• Patient Videos

• Interviews

• Qualitative Research

Summary

• Key in success of project

• Most important question – why are you involving patients?

• One size does not fit all – use different sources of engagement

Thank You