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

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.
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