Newman Bronwyn, Chin Melvin, Robinson Louisa, Chauhan Ashfaq, Manias Elizabeth, Wilson Carlene, Harrison Reema
Australian Institute for Health Innovation, Macquarie University, Sydney, Australia.
South Eastern Sydney Local Health District, Randwick, Australia.
JMIR Res Protoc. 2023 Sep 18;12:e49902. doi: 10.2196/49902.
People from ethnic minorities are often exposed to unsafe care contributing to poorer health care outcomes. Medication safety is a high-risk area requiring intervention to improve care outcomes. Using an adapted, experience-based co-design process with cancer service staff and patients from ethnic minorities, a medication communication tool was created: Making it Meaningful (MiM).
We aim to test whether the MiM tool is feasible and acceptable for use with ethnic minority consumers in cancer services in Australia.
A single site, controlled before and after this pilot study, will be used. Patients from Mandarin- and Russian-speaking backgrounds are eligible for inclusion. In total, 40 patients from these cultural backgrounds will be recruited and stratified by language to the intervention and control groups, with 20 participants in the intervention and 20 in the control group. Further, 4 health practitioners will be recruited and trained to use the MiM. Clinicians providing care for patients in the intervention will use the MiM during their usual appointment while providing medication communication using standard care processes for the control group. Telephone surveys will be conducted with participants at 3 time points, T1 before the intervention, T2 1 week post intervention, and T3 1 month post intervention, to assess knowledge and self-efficacy in medication management, perceived usability, and acceptability of the MiM. Qualitative interviews with clinicians who have used the MiM will be conducted 1 month postintervention to explore their perceptions of MiM feasibility and acceptability.
Ethical approval for this research has been provided by the South Eastern Sydney Area Health Human Research Ethics Committee (HRECXXX). Bilingual field-workers, 1 Mandarin-speaking and 1 Russian-speaking, are contacting eligible patients to enroll. It is anticipated that recruitment will be completed by October 2023, with data collection completed by December 2023.
Using experience-based co-design, we identified communication about medication, particularly between appointments, as a key issue impacting the safety of care for patients from ethnic minorities accessing cancer services. Increasing consumer engagement in medication management was identified as a strategy to reduce medication safety problems in cancer care; the MiM strategy was developed to address this issue. It is anticipated that by using the MiM, patient knowledge about prescribed medications and confidence in medication management will increase. Evidence from the pilot study will be used to inform a full-scale trial of the MiM tool with a range of ethnic minority communities accessing cancer services. A full-scale trial will seek to determine whether the MiM intervention is effective in knowledge and confidence about medication management, but also whether this improves patient outcomes in cancer care.
Australian New Zealand Clinical Trials ACTRN12622001260718p; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384658&isReview=true.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/49902.
少数民族人群常常面临不安全的医疗护理,这导致了较差的医疗保健结果。用药安全是一个高风险领域,需要进行干预以改善护理结果。通过与癌症服务工作人员和少数民族患者采用适应性的、基于经验的协同设计流程,创建了一种用药沟通工具:使其有意义(MiM)。
我们旨在测试MiM工具在澳大利亚癌症服务中与少数民族消费者一起使用是否可行且可接受。
将采用单中心、此试点研究前后对照的方式。讲普通话和俄语背景的患者符合纳入条件。总共将招募40名来自这些文化背景的患者,并按语言分层分为干预组和对照组,干预组20名参与者,对照组20名。此外,将招募4名医疗从业者并培训他们使用MiM。为干预组患者提供护理的临床医生在其常规预约期间将使用MiM,而对照组则使用标准护理流程进行用药沟通。将在3个时间点对参与者进行电话调查,干预前的T1、干预后1周的T2和干预后1个月的T3,以评估用药管理方面的知识和自我效能、MiM的感知可用性和可接受性。干预后1个月将对使用过MiM的临床医生进行定性访谈,以探讨他们对MiM可行性和可接受性的看法。
本研究已获得东南悉尼地区卫生人类研究伦理委员会(HRECXXX)的伦理批准。1名讲普通话和1名讲俄语的双语现场工作人员正在联系符合条件的患者进行招募。预计招募工作将于2023年10月完成,数据收集将于2023年12月完成。
通过基于经验的协同设计,我们确定用药沟通,尤其是预约之间的沟通,是影响少数民族癌症服务患者护理安全的关键问题。提高消费者在用药管理方面的参与度被确定为减少癌症护理中用药安全问题的一项策略;开发MiM策略以解决此问题。预计通过使用MiM,患者对处方药的了解以及用药管理的信心将会增加。试点研究的证据将用于为MiM工具在一系列获得癌症服务的少数民族社区中进行全面试验提供信息。全面试验将试图确定MiM干预在用药管理知识和信心方面是否有效,以及这是否能改善癌症护理中的患者结局。
澳大利亚新西兰临床试验注册中心ACTRN12622001260718p;https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384658&isReview=true。
国际注册报告识别码(IRRID):DERR1-10.2196/49902。