Exploring patient participation in reducing health-care-related safety risks

More documents

Recommendations

Info

Exploring patient participation in reducing health-care-related safety risks 88 The number of reported ADRs has increased since 2004 due to unsafe prescribing practices that do not observe the necessary limitations on use of medicines. Research indicates that medicines have been prescribed to populations known to be susceptible to a certain type of ADR. The fact that 38% of the doctors that responded to the survey treated patients with ADRs resulting from use of dietary supplements or herbal remedies points to a problem with the commercial information on dietary supplements in patient information leaflets. These may emphasize the anticipated advantages without highlighting the potential risks (adverse reactions that might result from medicines interactions and the ADRs these supplements may induce). A similar observation relates to herbal medicines. These are commonly considered to be very safe, yet research proves this assumption to be untrue, as herbal substances may modify the performance of other medicines and also induce serious ADRs (8). An additional reason for ADRs and drug-induced illness can be the nonstandardized content of a patient’s medical history, alongside medical professionals’ characteristic lack of interest in the patient’s medicine profile. This can lead to unacceptable repeated exposure to certain drugs in patients in which interactions and previous drug hypersensitivity have already been recorded. Recommendations The study results point to two main findings: 1 . poor medicine practices existing at PHC level, in terms of: doctors’ interest in patients’ medicine profiles; quality of medicines information provided to patients during visits; content of communication regarding patient medicines; and ADR reporting rates; and 2 . poor quality and low volume of patient education concerning pharmacotherapy and the inadequate use of potential sources of medicines information, as well as the absence of patient- and provider-focused medication information centres. These findings – if validated on a larger scale – require urgent communication with appropriate authorities and stakeholders to determine initiatives required to improve pharmacotherapy safety at PHC level. The recommendations that follow are made with respect to: (a) the health care system level; (b) the professional level; and (c) the patient level. Recommendation 1 – Organize medication information centres (health care system level) Continuous pharmacotherapy use calls for a system of medication information centres to be set up for patients, doctors, pharmacists and other stakeholders. Such centres would provide broad-scale, reliable information about medicines, indications, contraindications, interactions and the principles of safe and effective polypharmacotherapy. Added value would be attributed by learning to link medications in a rational way, using their complementary performance mechanisms and limiting polypharmacy (linking medications that do not contribute to increasing joint therapeutic effects, but rather
Patient safety, rights and medication safety in primary care in Poland raise the risk of ADRs). Such a system would also prevent the linking of medications with a similar profile of adverse reactions, consequently reducing the risk of increasing drug toxicity during the combined use of medicines. An alternative might be for on-call family doctors to provide information on medicines use. Recommendation 2 – Implement an electronic health card (health care system level) There is a need for the wide-scale implementation of an electronic health card, storing reliable information about medications taken, dosage and ADRs experienced. Lack of knowledge about medicine names and doses can result in serious consequences in emergency situations and/or sudden hospital admissions – it is crucial that hospital/ emergency staff know what medicines patients have recently taken. Some unexpected incidents such as hypotension, collapse, loss of consciousness, convulsions and heart rhythm disorders resulting in emergency admissions to hospital can also be the result of ADRs. The increasing complexity of polypharmacotherapy might lead to errors in terms of overdose or medicine withdrawal symptoms, because the more medicines taken, the less patients appear to know about their names and appropriate dosages. This is especially important in patients over the age of 65 years, who represent 14% of the Polish population and consume over 40% of all medications prescribed. It is therefore crucial to verify the perception of doctors’ instructions regarding medications for this population group (9). Recommendation 3 – Improve professional competences (health professional level) All health professionals should recognize the value of patient involvement and have access to sound basic-level and continuing education that covers clinical knowledge and medicine therapies, clinical guidelines, communication skills, human relationships and safe medication practices. Professional competences should be regularly evaluated. Information needs of different populations and special groups, such as older people, children, disabled people, migrants and individuals with low levels of health literacy, should be taken into account. Information on medicines provided to patients needs to include the choice of the most appropriate treatment for their health problem, including “non-drug” options – it should be comprehensive and understandable information about the expected therapeutic effects, potential ADRs and instructions for taking the medicine. Health professionals need to be trained to use medicine information sources and communicate about medicines with peers and patients to induce compliance during long-term pharmacotherapy. In addition, there is a need not only for education, but also for enforcement mechanisms (including incentives) relating to the practice of reporting ADRs to the designated and specialized centres for pharmacotherapy monitoring safety. Recommendation 4 – Provide medication information in an understandable way (health professional level) Professionals are expected to provide information on the names of drugs, dosages and timing of medicines administration in an understandable manner, with letters and numbers clearly distinguishable. The patient’s understanding of the doctor’s orders should always be verified. Safe medication practice would require that the patient obtains information about what common medicines should be taken in case of headache, toothache, diarrhoea or heartburn, particularly when prescribing drugs with a high probability of interaction. 89
Page 1 and 2:
Exploring patient participation in
Page 3 and 4:
ABSTRACT Patients’ rights have be
Page 5 and 6:
iv Patient information: the link be
Page 7 and 8:
vi LIST OF TABLES, FIGURES AND BOXE
Page 9 and 10:
ACKNOWLEDGEMENTS The editors would
Page 11 and 12:
LIST OF ABBREVIATIONS ABHR alcohol-
Page 13 and 14:
FOREWORD Health is a social value a
Page 15 and 16:
ChApTER 1. pATIENTS’ RIGhTS AND p
Page 17 and 18:
Box 1 .1 . contd Reporting and Lear
Page 19 and 20:
The causal mechanisms through which
Page 21 and 22:
» be involved in routine monitorin
Page 23 and 24:
elationships within the complex env
Page 25 and 26:
ChApTER 2. pATIENTS’ RIGhTS AND p
Page 27 and 28:
CoE Recommendation 2006/7 of the Co
Page 29 and 30:
The 2005 United States act on patie
Page 31 and 32:
The right to participate in policy-
Page 33 and 34:
The right to participate in quality
Page 35 and 36:
» engaging with patient representa
Page 37 and 38:
hampered by the written and spoken
Page 39 and 40:
prevents misunderstandings and shap
Page 41 and 42:
Health care providers should nevert
Page 43 and 44:
Recommendation 7 - Encourage the av
Page 45 and 46:
20. Constitution of the World Healt
Page 47 and 48:
ChApTER 3. pATIENT pARTICIpATION IN
Page 49 and 50:
awareness of the sociomedical burde
Page 51 and 52: Patient participation in hand hygie
Page 61 and 62: Blood transfusion safety in France:
Page 65 and 66: Box 4 .1 . Definitions of adverse e
Page 67 and 68: Fig . 4 .4 . Distribution of advers
Page 73 and 74: The heterogeneity of situations and
Page 83 and 84: Fig . 4 .12 . Patients’ response
Page 91 and 92: Patient safety, rights and medicati
Page 97 and 98: Fig . 5 .3 . Frequency with which d
Page 101: Patient safety, rights and medicati
Page 107 and 108: ChApTER 6. pATIENT pARTICIpATION IN
Page 109 and 110: Patient participation in elective s
Page 111 and 112: e desirable to have a special statu
Page 117 and 118: inspections of surgical services to
Page 133 and 134: » being involved in monitoring and
Page 135 and 136: Other studies on patient attitudes
Page 137 and 138: Information about patients’ exper
Page 139 and 140: available evidence suggests that in
Page 141 and 142: Adverse events Respondents from the
Page 143 and 144: Feeling safe Five per cent of hospi
Page 145 and 146: probability proportional to populat
Page 147 and 148: care professionals’ and patients
Page 149 and 150: group recommends that patient invol
Page 151 and 152: 13. Hibbard JH et al. Can patients
Page 153 and 154:
52. Triemstra M et al. Measuring cl
Page 155 and 156:
2009 (http://www.bradfordresearch.n
Page 157 and 158:
of a small-scale patient survey add
Page 159 and 160:
Box 8 .2 . Curricula and CME Chapte
Page 161 and 162:
is provided through interaction of
Page 163 and 164:
Box 8 .4 . Patient education Chapte
Page 165 and 166:
ANNEX 1. QUOTATIONS FROM INTERNATIO
Page 167 and 168:
(2) When designing adverse event re
Page 169 and 170:
17) If yes, do you think this was m
Page 171 and 172:
Box A3 .1 . Reporting procedure Pat
Page 173 and 174:
Box A3 .2 . contd Haemosiderosis Ha
Page 175 and 176:
ANNEX 4. pATIENT QUESTIONNAIRE ABOU
Page 177 and 178:
ANNEX 6. WhO pATIENT SAFETY pROGRAM
Page 179 and 180:
especially those in intensive care.
Page 181 and 182:
ANNEX 7. hANDOVER pROjECT Paul Bara
Page 183 and 184:
(a) Provide new insight into the ro
Page 185 and 186:
Johnson J, Barach P. Handovers of p
Page 187 and 188:
Enhancing the patients’ role in p
Page 189 and 190:
Enhancing the patients’ role in p
show all

Exploring patient participation in reducing health-care-related safety risks

Create successful ePaper yourself

Delete template?

Save as template?