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促进患者与医疗保健专业人员合作的数字共享用药计划的价值主张:共同设计研究

Value Propositions for Digital Shared Medication Plans to Boost Patient-Health Care Professional Partnerships: Co-Design Study.

作者信息

Bugnon Benjamin, Bosisio Francesca, Kaufmann Alain, Bonnabry Pascal, Geissbuhler Antoine, von Plessen Christian

机构信息

School of pharmaceutical sciences, Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland.

CARA Association, Épalinges, Switzerland.

出版信息

J Particip Med. 2025 Jan 28;17:e50828. doi: 10.2196/50828.

Abstract

BACKGROUND

Health authorities worldwide have invested in digital technologies to establish robust information exchange systems for improving the safety and efficiency of medication management. Nevertheless, inaccurate medication lists and information gaps are common, particularly during care transitions, leading to avoidable harm, inefficiencies, and increased costs. Besides fragmented health care processes, the inconsistent incorporation of patient-driven changes contributes to these problems. Concurrently, patient-empowerment tools, such as mobile apps, are often not integrated into health care professional workflows. Leveraging coproduction by allowing patients to update their digital shared medication plans (SMPs) is a promising but underused and challenging approach.

OBJECTIVE

This study aimed to determine the value propositions of a digital tool enabling patients, family caregivers, and health care professionals to coproduce and co-manage medication plans within Switzerland's national eHealth architecture.

METHODS

We used an experience-based co-design approach in the French-speaking region of Switzerland. The multidisciplinary research team included 5 patients as co-researchers. We recruited polypharmacy patients, family caregivers, and health care professionals with a broad range of experiences, diseases, and ages. The experience-based co-design had 4 phases: capturing, understanding, and improving experiences, followed by preparing recommendations and next steps. A qualitative, participatory methodology was used to iteratively explore collaborative medication management experiences and identify barriers and enabling mechanisms, including technology. We conducted a thematic analysis of participant interviews to develop value propositions for digital SMPs.

RESULTS

In total, 31 persons participated in 9 interviews, 5 focus groups, and 2 co-design workshops. We identified four value propositions for involving patients and family caregivers in digital SMP management: (1) comprehensive, accessible information about patients' current medication plans and histories, enabling streamlined access and reconciliation on a single platform; (2) patient and health care professional empowerment through the explicit co-ownership of SMPs, fostering coresponsibility, accountability, and transparent collaboration; (3) a means of supporting collaborative interprofessional medication management, including tailored access to information and improved communication across stakeholders; and (4) an opportunity to improve the quality of care and catalyze digital health innovations. Participants discussed types of patient involvement in editing shared information and emphasized the importance of tailoring SMPs to individual abilities and preferences to foster health equity. Integrating co-management into the clinical routine and creating supportive conditions were deemed important.

CONCLUSIONS

Coproduced SMPs can improve medication management by fostering trust and collaboration between patients and health care professionals. Successful implementation will require eHealth interoperability frameworks that embrace the complexity of medication management and support diverse use configurations. Our findings underscored the shared responsibility of all stakeholders, including policy makers and technology providers, for the effective and safe use of SMPs. The 4 value propositions offer strategic guidance, while highlighting the need for further research in different health care settings.

摘要

背景

全球卫生当局已投资于数字技术,以建立强大的信息交换系统,以提高药物管理的安全性和效率。然而,不准确的药物清单和信息差距很常见,尤其是在护理过渡期间,这会导致可避免的伤害、效率低下和成本增加。除了医疗保健流程碎片化外,患者驱动的变化未得到一致整合也导致了这些问题。同时,患者赋权工具,如移动应用程序,往往未集成到医疗保健专业人员的工作流程中。通过允许患者更新其数字共享药物计划(SMP)来利用共同生产是一种有前景但未充分利用且具有挑战性的方法。

目的

本研究旨在确定一种数字工具的价值主张,该工具使患者、家庭护理人员和医疗保健专业人员能够在瑞士国家电子健康架构内共同生产和共同管理药物计划。

方法

我们在瑞士法语区采用了基于经验的协同设计方法。多学科研究团队包括5名患者作为共同研究人员。我们招募了患有多种药物治疗疾病、具有广泛经验、疾病和年龄的患者、家庭护理人员和医疗保健专业人员。基于经验的协同设计有4个阶段:捕捉、理解和改进经验,然后准备建议和下一步计划。我们使用定性、参与式方法来迭代探索协作药物管理经验,并确定障碍和促成机制,包括技术。我们对参与者的访谈进行了主题分析,以制定数字SMP的价值主张。

结果

共有31人参加了9次访谈、5次焦点小组讨论和2次协同设计研讨会。我们确定了让患者和家庭护理人员参与数字SMP管理的四个价值主张:(1)关于患者当前药物计划和病史的全面、可访问信息,可在单个平台上实现简化访问和核对;(2)通过明确共同拥有SMP赋予患者和医疗保健专业人员权力,促进共同责任、问责制和透明协作;(3)支持跨专业协作药物管理的一种手段,包括量身定制的信息访问和改善利益相关者之间的沟通;(4)提高护理质量和推动数字健康创新的机会。参与者讨论了患者参与编辑共享信息的类型,并强调根据个人能力和偏好定制SMP以促进健康公平的重要性。将共同管理纳入临床常规并创造支持性条件被认为很重要。

结论

共同生产的SMP可以通过促进患者和医疗保健专业人员之间的信任与协作来改善药物管理。成功实施将需要电子健康互操作性框架,该框架要涵盖药物管理的复杂性并支持多种使用配置。我们的研究结果强调了包括政策制定者和技术提供商在内的所有利益相关者对有效和安全使用SMP的共同责任。这四个价值主张提供了战略指导,同时突出了在不同医疗保健环境中进行进一步研究的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c71/11815291/70bd18447ec7/jopm_v17i1e50828_fig1.jpg

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