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Safer drug use in primary care - a pilot intervention study to identify improvement needs and make agreements for change in five Swedish primary care units

Modig, Sara LU ; Lenander, Cecilia LU ; Viberg, Nina LU and Midlöv, Patrik LU (2016) In BMC Family Practice 17(1). p.1-10
Abstract

Background: There is an urgent need to improve patient safety in the area of medication treatment among the elderly. The aim of this study was to explore which improvement needs and strengths, relating to medication safety, arise from a multi-professional intervention in primary care and further to describe and follow up on the agreements for change that were established within the intervention. Methods: The SÄKLÄK project was a multi-professional intervention in primary care consisting of self-assessment, peer-review, feedback and written agreements for change. Data were obtained from five primary care units randomised to the intervention group. Reviewer feedback reports and agreements for change were analysed using content analysis.... (More)

Background: There is an urgent need to improve patient safety in the area of medication treatment among the elderly. The aim of this study was to explore which improvement needs and strengths, relating to medication safety, arise from a multi-professional intervention in primary care and further to describe and follow up on the agreements for change that were established within the intervention. Methods: The SÄKLÄK project was a multi-professional intervention in primary care consisting of self-assessment, peer-review, feedback and written agreements for change. Data were obtained from five primary care units randomised to the intervention group. Reviewer feedback reports and agreements for change were analysed using content analysis. Results: Strengths that were identified included a committed leadership, work methods to enhance medication safety and access to consultants. Methods for securing an accurate medication list, knowledge and methods of working of the prescriber and patient's ability to contribute to medication safety were areas that gave rise to three predesigned categories for improvement needs on a local level. Another category became apparent during the analysis; namely learning from mistakes and from results. In all categories, apparent shortcomings were identified. These included inaccurate medication lists, lack of medication reconciliation, lack of time for follow-up of elderly patients, need for further education in geriatrics and pharmacotherapy and lack of information on indication and maximum dosage. An increased number of medication reviews were among the most common agreements for change seen. Conclusions: This study identified substantial shortcomings, like poorly updated medication lists, which affected medication safety in the participating Swedish primary care units. Similar shortcomings are most likely present in other primary care units in the country. Working together multi-professionally, including performing medication reviews, could be one way of improving medication safety. On the other hand, the individual physician must possess enough pharmaceutical knowledge and the working conditions must allow time for follow-up of prescriptions. Strengths of the primary care unit, such as successful methods of working, must be taken advantage of. The culture in primary care may affect the ability to successfully implement routines that improve patient safety and reduce risk of medication errors.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Elderly, Medication reconciliation, Medication safety, Peer-Review, Primary care, Self-assessment
in
BMC Family Practice
volume
17
issue
1
pages
10 pages
publisher
BioMed Central
external identifiers
  • scopus:84990857929
  • wos:000384613800001
ISSN
1471-2296
DOI
10.1186/s12875-016-0542-8
language
English
LU publication?
yes
id
1c25d59d-799c-4e49-b6be-87947dd195bb
date added to LUP
2016-11-16 08:56:20
date last changed
2017-01-01 08:39:43
@article{1c25d59d-799c-4e49-b6be-87947dd195bb,
  abstract     = {<p>Background: There is an urgent need to improve patient safety in the area of medication treatment among the elderly. The aim of this study was to explore which improvement needs and strengths, relating to medication safety, arise from a multi-professional intervention in primary care and further to describe and follow up on the agreements for change that were established within the intervention. Methods: The SÄKLÄK project was a multi-professional intervention in primary care consisting of self-assessment, peer-review, feedback and written agreements for change. Data were obtained from five primary care units randomised to the intervention group. Reviewer feedback reports and agreements for change were analysed using content analysis. Results: Strengths that were identified included a committed leadership, work methods to enhance medication safety and access to consultants. Methods for securing an accurate medication list, knowledge and methods of working of the prescriber and patient's ability to contribute to medication safety were areas that gave rise to three predesigned categories for improvement needs on a local level. Another category became apparent during the analysis; namely learning from mistakes and from results. In all categories, apparent shortcomings were identified. These included inaccurate medication lists, lack of medication reconciliation, lack of time for follow-up of elderly patients, need for further education in geriatrics and pharmacotherapy and lack of information on indication and maximum dosage. An increased number of medication reviews were among the most common agreements for change seen. Conclusions: This study identified substantial shortcomings, like poorly updated medication lists, which affected medication safety in the participating Swedish primary care units. Similar shortcomings are most likely present in other primary care units in the country. Working together multi-professionally, including performing medication reviews, could be one way of improving medication safety. On the other hand, the individual physician must possess enough pharmaceutical knowledge and the working conditions must allow time for follow-up of prescriptions. Strengths of the primary care unit, such as successful methods of working, must be taken advantage of. The culture in primary care may affect the ability to successfully implement routines that improve patient safety and reduce risk of medication errors.</p>},
  author       = {Modig, Sara and Lenander, Cecilia and Viberg, Nina and Midlöv, Patrik},
  issn         = {1471-2296},
  keyword      = {Elderly,Medication reconciliation,Medication safety,Peer-Review,Primary care,Self-assessment},
  language     = {eng},
  month        = {10},
  number       = {1},
  pages        = {1--10},
  publisher    = {BioMed Central},
  series       = {BMC Family Practice},
  title        = {Safer drug use in primary care - a pilot intervention study to identify improvement needs and make agreements for change in five Swedish primary care units},
  url          = {http://dx.doi.org/10.1186/s12875-016-0542-8},
  volume       = {17},
  year         = {2016},
}