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 28 th June 2011

Overview ImPE Project Patient Public Involvement Medication Passport Workshop Summary

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 Improving Prescribing in the Elderly (ImPE Project) Aims

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

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

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

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 Passport was redesigned based on comments from reader group This was taken to a further reader group and external organisations for comments Ratified by project team

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

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

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 community healthcare team Presentation Text, colour, layout, Ease of understanding, completion Usefulness Recommend to family/friend/HCP

Workshop Split into 4 groups

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.

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

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

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

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

Thank You