The blind leading the blind: Co-production of medication safety solutions for people with sight impairment in community pharmacy
The blind leading the blind: Co-production of medication safety solutions for people with sight impairment in community pharmacy
复制标题
盲人引导盲人：社区药房视力障碍者用药安全解决方案联合生产
DOI：
10.1093/ijpp/riad074.058
复制
发表时间：
2023
影响因子：
1.8
通讯作者：
Riste L
中科院分区：
文献类型：
--
作者：
Riste L
英国每年约发生2.37亿起用药差错，估计费用达9800万英镑1。我们进行了一项范围审查，发现视力障碍者是一个错误风险很高的群体(正在审查中)。目的通过开发一款帮助视力障碍者管理药物的应用程序来提高他们的用药安全性。方法我们参加了由英国曼彻斯特的亨肖视力丧失慈善机构领导的最初的面对面‘茶与科技’利益相关者小组，并从视力障碍者的用药经历中寻求反馈。这项研究获得了曼彻斯特大学研究伦理委员会(参考编号：2021-11098-18381)的伦理批准。共同设计研讨会-由于持续的新冠肺炎大流行，我们举办了两个在线研讨会，最大限度地减少出差和面对面会议的需要2。RNIB在他们的“社区连接器”中促进了讲习班。我们NIHR大曼彻斯特患者安全翻译研究中心的社区药剂师也被邀请参加，提供他们作为医疗保健专业人员的观点。会议由患者安全研究人员和研究人员共同主持。第一次研讨会(2021年6月)集中讨论视力障碍者在使用药物方面的经验，以及可能的解决方案。第二次研讨会(2021年7月)对这些潜在的解决方案进行了排名，确定了开发的优先顺序。结果参加茶技小组的人警告不要开发另一款应用程序，强调他们在安装和使用应用程序时存在的视力障碍造成的问题。联合设计研讨会有六名视力障碍者和六名社区药剂师参加。报告的困难包括无法区分药物，无法获取(药物标签上的)剂量说明和产品信息传单中的安全信息。最重要的解决方案是1)与药剂师一对一的咨询，2)改进药物包装，3)药剂师培训的必要性。讨论突出了药剂师缺乏可靠地识别视力障碍者的系统。这导致我们开发了一种名为Find Logo并给出用药建议(FLAG-Me Vision)的药房软件系统，该系统使用电子健康记录中的现有数据识别视力障碍者。患者用药记录上的屏幕警告(显示为徽标)提示药房工作人员提供一对一咨询。我们网站(www.lag-me.org)上提供的资源支持咨询，并符合药剂师培训的职责。我们的原型软件由曼彻斯特大学的Imago学生软件公司创建，使用虚拟NHS记录和医院运行(开源软件)进行了测试。讨论/结论FLAG-Me Vision的市场发现和测试是通过iCURe Discovery程序3进行的。反馈是，FLAG-Me Vision很受视力障碍者和药剂师的欢迎。未来的计划包括在大曼彻斯特的一个社区药房连锁店内与药房软件供应商一起试用该软件。Elliot RA，Camacho E，Jankovic D.英格兰用药差错的流行率、临床和经济负担的经济分析。BMJ Qual Saf.2021；30：(2)96-1052。阿德耶米I，桑德斯C，王…
IntroductionAround 237 million medication errors occur each year in England, with an estimated cost of £98 million1. We carried out a scoping review identified that people with sight impairments were a group at high risk of errors (under review).AimTo improve medication safety for people with sight impairments by developing an ‘App’ to help them manage medications.MethodsWe attended an initial in-person ‘Tea and Tech’ stakeholder group led by Henshaws Sight Loss charity in Manchester, UK and sought feedback from people with sight impairments about their experiences of medication.Ethical approval for this study was granted by The University of Manchester Research Ethics Committee (Ref: 2021-11098-18381).Co-design workshops – Due to the ongoing COVID-19 pandemic, we held two online workshops, minimising the need for travel and face to face meetings2. Workshops were promoted by RNIB amongst their ‘Community Connectors’. Community Pharmacists who were part of our NIHR Greater Manchester Patient Safety Translational Research Centre were also invited to participate to provide their perspective as healthcare professionals. Sessions were co-facilitated by patient safety researchers and researchers acting as notetakers.The first workshop (June 2021), focussed on the experiences of people with sight impairment around using medication, and potential solutions to these. The second workshop (July 2021), ranked these potential solutions, prioritising ideas for development.ResultsThose attending the Tea and Tech group warned against developing ‘another App’, highlighting problems caused by their sight impairment around installing and using ‘Apps’ generally.Co-design workshops were attended by six people with sight impairment and six community pharmacists. The difficulties reported included inability to distinguish between medications, to access dosing instructions (on medication labels) and safety information within product information leaflets. The solutions ranked as most important were 1) one to one consultations with pharmacists 2) improving medication packaging and 3) the need for pharmacist training.Discussions highlighted the lack of a system for pharmacists to reliably identify people with sight impairments.This led us to develop a pharmacy software system called Find Logo And Give Medication advice (FLAG-Me Vision) which identifies people with sight impairments using existing data within the electronic health record. An on-screen alert (shown as a logo) on the patient medication record, prompts pharmacy staff to offer a one-to-one consultation. Resources available on our website (www.flag-me.org) supports consultations and meets the remit for pharmacist training.Our prototype software created by Imago Student Software company at The University of Manchester, was tested using dummy NHS records and Hospital Run (open-source software).Discussion/ConclusionMarket discovery and testing for FLAG-Me Vision has been undertaken via iCURe DISCOVER programme3. Feedback is that FLAG-Me Vision is well received by people with sight impairments and pharmacists alike. Future plans include piloting this software with pharmacy software suppliers within one community pharmacy chain in Greater Manchester.References1. Elliot RA, Camacho E, Jankovic D. Economic analysis of the prevalence and clinical and economic burden of medication error in England. BMJ Qual Saf. 2021;30:(2)96-1052. Adeyemi I, Sanders C, Ong …