The patient-public-led development of a “Medication Passport‟

1. The patient-public-led development of a “Medication Passport‟ Kandarp Thakkar Lead Pharmacist – Admissions Project Manager Saadia Jamil Senior Pharmacist – Admissions Project Support Making Healthcare Safer 28th June 2011

2. Overview • ImPE Project • Patient Public Involvement • Medication Passport • Workshop • Summary

3. Improving Prescribing in the Elderly (ImPE Project)Aims • To develop a medication review system based on an evidence based tool (“STOPP” – Screening Tool of Older Persons potentially inappropriate Prescriptions) for use with elderly patients across all sectors and interfaces of care • And providing patients with better information about their medicines

4. CLAHRC • Collaboration for Leadership in Applied Health Research & Care • 9 CLAHRC’s – each £10m over 5 years –NIHR funded and managed • Focus - Cooksey’s "second gap in translation“ • (Review of Health Research) • Main aim - to support the translation of research evidence into practice in the NHS

5. Standard NHS approach to quality improvement • Quality Improvement Methodology • Process mapping • Action Effect diagram • Plan Do Study Act (PDSA) cycles • Sustainability assessments and action • Strong Patient and Public Involvement (PPI)

7. Patient Public Involvement • To explore what sort of information patients need about medicines • To take part in the creation of different modes of getting this information • To ensure understanding of patients using surveys and interviews

8. Medication passport idea originated from focus group Discussed with multiprofessional project team including patient representation A mock-up of the passport was taken to a reader group This was taken to a further reader group and external organisations for comments Passport was redesigned based on comments from reader group Ratified by project team

10. uncertainty about who is responsible/ liable for communicating these changes Not being told why they are changing my medication Lack of information about the new medicine lack of staff continuity which hinders effective communication Who is responsible for my medication changes?

11. Medication Passport – evaluation • Evaluation currently underway • Quantitative surveys and qualitative interviews / videos • Further focus group planned

12. Results – Survey of Medicines Passport users Overwhelming agreement/satisfaction with . . . Function To carry around and show anyone involved with patient care To ensure transfer of info between different sectors of care To ensure transfer of info between the healthcare team in hospital To ensure transfer of info between the communityhealthcare team Presentation Text, colour, layout, Ease of understanding, completion Usefulness Recommend to family/friend/HCP

14. Workshop • Split into 4 groups

15. Challenges with PPI • Recruitment • What best fits team and project • Project team meetings • Effective chairing • Communication • Hidden Agenda • Getting the most relevant points • Language barrier • Complaints – ‘buddy’ system • Logistics – Contract, CRB etc.

16. How do you engage patients? • ‘Expert’ patient(s) on project steering group • Focus groups • Reader groups • Public facing national organisations e.g. Age UK • Local organisations e.g. LINKS, Hestia • Patients from other projects • ‘Real’ patients i.e. inpatients

17. Benefits of PPI and how to harness • The patient perspective • Attention to detail we would ignore • Using patients as service users in design vs comments after design • Use a range of PPI involvement methods

18. Using patients in evaluation • Surveys – involving patients in design • Patient Videos • Interviews • Qualitative Research

19. Summary • Key in success of project • Most important question – why are you involving patients? • One size does not fit all – use different sources of engagement

20. Thank You