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安全消息传递在医疗护理转接过程中用于药物重整的感知有效性:对患者的半结构化访谈

The Perceived Effectiveness of Secure Messaging for Medication Reconciliation During Transitions of Care: Semistructured Interviews With Patients.

作者信息

Brady Julianne E, Linsky Amy M, Simon Steven R, Yeksigian Kate, Rubin Amy, Zillich Alan J, Russ-Jara Alissa L

机构信息

Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, United States.

General Internal Medicine, VA Boston Healthcare System, Boston, MA, United States.

出版信息

JMIR Hum Factors. 2022 Aug 3;9(3):e36652. doi: 10.2196/36652.

Abstract

BACKGROUND

Medication discrepancies can lead to adverse drug events and patient harm. Medication reconciliation is a process intended to reduce medication discrepancies. We developed a Secure Messaging for Medication Reconciliation Tool (SMMRT), integrated into a web-based patient portal, to identify and reconcile medication discrepancies during transitions from hospital to home.

OBJECTIVE

We aimed to characterize patients' perceptions of the ease of use and effectiveness of SMMRT.

METHODS

We recruited 20 participants for semistructured interviews from a sample of patients who had participated in a randomized controlled trial of SMMRT. Interview transcripts were transcribed and then qualitatively analyzed to identify emergent themes.

RESULTS

Although most patients found SMMRT easy to view at home, many patients struggled to return SMMRT through secure messaging to clinicians due to technology-related barriers. Patients who did use SMMRT indicated that it was time-saving and liked that they could review it at their own pace and in the comfort of their own home. Patients reported SMMRT was effective at clarifying issues related to medication directions or dosages and that SMMRT helped remove medications erroneously listed as active in the patient's electronic health record.

CONCLUSIONS

Patients viewed SMMRT utilization as a positive experience and endorsed future use of the tool. Veterans reported SMMRT is an effective tool to aid patients with medication reconciliation. Adoption of SMMRT into regular clinical practice could reduce medication discrepancies while increasing accessibility for patients to help manage their medications.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02482025; https://clinicaltrials.gov/ct2/show/NCT02482025.

摘要

背景

用药差异可能导致药物不良事件和患者伤害。用药核对是一个旨在减少用药差异的过程。我们开发了一种集成到基于网络的患者门户中的用药核对安全消息工具(SMMRT),以在患者从医院过渡到家庭期间识别并核对用药差异。

目的

我们旨在描述患者对SMMRT易用性和有效性的看法。

方法

我们从参与SMMRT随机对照试验的患者样本中招募了20名参与者进行半结构化访谈。访谈记录被转录,然后进行定性分析以识别新出现的主题。

结果

尽管大多数患者发现在家中查看SMMRT很容易,但许多患者由于技术相关障碍,难以通过安全消息将SMMRT反馈给临床医生。确实使用了SMMRT的患者表示,它节省时间,并且喜欢他们可以按照自己的节奏在舒适的家中查看它。患者报告称SMMRT在澄清与用药说明或剂量相关的问题方面很有效,并且SMMRT有助于删除在患者电子健康记录中错误列为有效的药物。

结论

患者将SMMRT的使用视为一种积极的体验,并认可该工具的未来使用。退伍军人报告称SMMRT是帮助患者进行用药核对的有效工具。将SMMRT应用于常规临床实践可以减少用药差异,同时增加患者管理药物的可及性。

试验注册

ClinicalTrials.gov NCT02482025;https://clinicaltrials.gov/ct2/show/NCT02482025

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/321c/9386577/a4cb54ad8300/humanfactors_v9i3e36652_fig1.jpg

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