Leveraging a Social Network of Elders and Families To Improve Medication Safety at Transitions of Care

项目摘要 患者及其家属通常难以管理药物，特别是在护理过渡期间。 出院后的所有不良事件中有三分之二与药物有关。的问题 药物管理是放大老年患者，谁往往是多种药物， 副作用和药物相互作用可能导致更多的伤害。 InfoSAGE（跨代信息共享）是一个现有的AHRQ支持的研究项目， 旨在了解和解决75岁及以上老年人的信息和护理协调需求， 以及参与照顾他们的家人。研究参与者使用在线私人社交网络， 专为项目（https：//www.example.com）构建，用于查找资源并管理任务和通信。www.infosagehealth.org 我们的方法以一种新的方式使用健康信息技术，创建一个基于社区的平台， 改善护理协调、患者和家庭赋权，并最终改善患者安全。 在这个项目中，我们建议扩展InfoSAGE平台的功能，包括移动优先/点- of-care药物管理器帮助老年人及其家人保持准确的药物清单， 与处方临床医生协调列表，跟踪药物对症状的影响，查看 药物预防措施和药物相互作用，并成为更多参与他们的护理合作伙伴。 我们将确定使用共享在线药物列表的促进因素和障碍，评估可用性， 该工具所需的电子卫生知识，并衡量其采用和使用情况。然后我们将研究 药物安全工具，并确定增加对该工具的参与是否会改善共同决策- 使有关药物和减少不适当的使用药物和多药。 我们的长期目标是开发一套使用在线和移动的工具的最佳实践， 药物管理。

Project Summary Patients and their families often have difficulty managing medications, especially across transitions of care. Two-thirds of all adverse events following hospital discharge are related to medications. The problem of medication management is magnified for older patients, who are often on multiple medications and for whom side effects and drug-drug interactions may lead to more harm. InfoSAGE (Information Sharing Across Generations) is an existing AHRQ-supported research project that seeks to understand and address information and care coordination needs of older adults, age 75 and above, and their families who are involved in their care. Research participants use an online private social network, built for the project (https://www.infosagehealth.org), to find resources and manage tasks and communications. Our approach uses health information technology in a new way, creating a community-based platform to improve care coordination, patient and family empowerment, and ultimately improve patient safety. In this project, we propose to expand the functionality of the InfoSAGE platform to include a mobile-first/point- of-care medication manager to help elderly people and their families keep an accurate medication list, coordinate the list with the prescribing clinicians, track the impact of medications on symptoms, view medication precautions and drug-drug interactions, and become more engaged as partners in their care. We will determine facilitators and barriers to the use of a shared online medication list, assess the usability and e-Health literacy needed for the tool, and measure its adoption and usage. We will then study the impact of the tool on medication safety and determine if increased engagement with the tool improves shared decision- making about medications and reduces the inappropriate use of medications and polypharmacy. Our long-term goal is to develop a set of best practices for the use of online and mobile tools for complex medication management.