Towards understanding and improving medication safety for patients with mental illness in primary care: a multimethod study

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Abstract

Introduction: Medication safety incidents have been identified as an important target to improve patient safety in mental healthcare. Despite this, the causes of preventable medication safety incidents affecting patients with mental illness have historically been poorly understood with research now addressing this knowledge gap through a healthcare professional lens. However, patients and carers can also provide complimentary insight into safety issues and as key stakeholders in healthcare, it is vital to consider their needs when designing effective interventions.
Methods: A two-stage approach was adopted by (i) conducting three focus groups comprising of 13 patients with mental illness and their carers to develop a holistic picture of medication safety in primary care with extraction of themes guided by the P-MEDS framework; (ii) conducting two separate nominal group consensus workshops with seven patients with mental illness/carers and seven healthcare professionals to identify priority areas for targeted interventions.
Results: Seven themes were identified in the focus groups: communication; trust, involvement and respect; continuity and support; access; the healthcare professional; the patient and carer; and the organisation. Priority areas identified for intervention by key stakeholders included improving communication within and between clinical services, enhancing patient support with holistic continuity of care, maximising shared decision-making and empowerment, ensuring timely access to medicines and services, strengthening healthcare professional knowledge regarding mental illnesses and associated medications, and increasing patient dignity and respect.
Conclusion: This study has developed a holistic picture of the contributors to medication safety incidents affecting patients with mental illness in primary care. This theory was then used by key stakeholders to inform and generate priority recommendations for targeted interventions. These findings can be used to inform future intervention research, as they consider the needs of those who access or work within primary care services.
Original languageEnglish
JournalHealth Expectations
Volume27
Issue number3
DOIs
Publication statusPublished - 30 May 2024

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