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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
- Source :
- BMC Family Practice
- Publication Year :
- 2016
- Publisher :
- Springer Science and Business Media LLC, 2016.
-
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. 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.
- Subjects :
- Further education
Self-assessment
Self-Assessment
medicine.medical_specialty
Time Factors
Pilot Projects
Patient Care Planning
Medication safety
Random Allocation
03 medical and health sciences
Patient safety
Medication Reconciliation
Elderly
0302 clinical medicine
Nursing
Surveys and Questionnaires
Intervention (counseling)
Humans
Medicine
030212 general & internal medicine
Medical prescription
Aged
Sweden
Geriatrics
Primary Health Care
Peer-Review
business.industry
030503 health policy & services
Continuity of Patient Care
Primary care
Quality Improvement
Content analysis
Polypharmacy
Patient Safety
0305 other medical science
Family Practice
business
Needs Assessment
Medication list
Research Article
Subjects
Details
- ISSN :
- 14712296
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- BMC Family Practice
- Accession number :
- edsair.doi.dedup.....d1290e579093edb8539564da3ffe1a33
- Full Text :
- https://doi.org/10.1186/s12875-016-0542-8