Capturing patients' perspectives on medication safety: the development of a patient-centered medication safety framework

Objectives: Medication safety incidents are common in primary care and
contributory factors frameworks can assist in our understanding of their
causes. A framework that is positioned from the perspective of patients
would be advantageous in practice when seeking patient insights into medication safety. The aim of this study was to develop a patient-centered contributory factors framework for examining medication safety incidents.
Methods: A purposive sample of 106 members of the public, patients,
and carers were recruited to take part in focus groups (n = 18). Focus
groups were audio recorded, transcribed, and analyzed using a thematic
framework. A patient and public involvement group was set up to undertake
multiple roles in the research process, including the development of
the focus group schedule, analysis of the data, and the construction of a
patient-centered framework of contributory factors (patient-centered medication
safety) and implementation checklist.
Results: The findings highlighted the importance of communication, supplies
of medication and appliances, patient- and carer-related factors, healthcare
professional factors, and computer systems and programs in the safe use
of medicines. Some contributory factors were unique to primary care patients
such as access to services and continuity of care. In conjunction with a patient
and public involvement group, a framework of factors that patients believe
contribute to medication safety incidents in primary care was developed that
could be used by patients and healthcare professionals.
Conclusions: The patient-centered medication safety framework and implementation checklist provides a novel tool to examine contributory factors
that can lead to medication safety incidents from patients' perspective.