EMPOWERING OLDER PEOPLE TO AVOID MEDICATION-RELATED HARM: A CO-PRODUCED COMMUNITY PHARMACY SOLUTION

据估计，英格兰每年有2.37亿次用药错误，造成或促成1,700人死亡，并使NHS损失9800万英镑（Elliot et al.，2021年）。错误可能包括人们服用错误的药物，对药物产生不良反应，或服用过多或过少。全球患者用药安全挑战旨在通过改善用药过程的每个阶段，包括处方、分发、管理、监测和使用，到2023年将严重的、可避免的药物相关伤害减少50%。（世卫组织，2017年）。某些群体发生这些错误的风险增加，老年人的风险更高，因为他们更有可能患有多种健康状况，并服用多种药物。英国年龄协会的一份报告估计，近200万65岁以上的人可能服用至少7种处方药，这可能导致老年人遭受可避免的伤害（NHS Digital，2016）。这种情况不仅发生在英国，而且发生在世界各地。在2015年至2050年期间，世界60岁以上人口的比例将从12%增加到22%（世卫组织，2022年）。我们的团队以前曾与视力障碍者（他们的用药错误风险增加）和社区药剂师合作开发Find Logo And Give MEDication Advice（FLAG-Me）Vision软件。我们的解决方案可以让药剂师知道一个人是否有视力障碍，并允许他们为患者提供1：1的咨询。我们网站上的策略和资源可以根据患者的需求量身定制。这些可能包括帮助区分药物的方法，找出药物标签上的内容和药物信息传单上的安全信息的方法。FLAG-Me Vision是一种解决方案，可以发现用药错误的高风险人群，并提醒药剂师他们可能需要额外的药物支持，以避免与药物相关的伤害。我们知道其他情况也可能在用药错误中发挥重要作用。我们将在焦点小组中与老年人讨论他们在药物治疗方面遇到的问题，并根据具体的健康状况对这些问题进行分类。听力问题可能意味着医生或护士的信息可能会被遗漏，或者记忆问题意味着人们只是忘记按处方服药，或者可能会服用过多或不属于他们的药物。因此，我们计划在整个项目中与老年人共同制作更多的FLAG-Me解决方案，以确保我们制作的任何产品都能满足他们的需求，也可以被社区药剂师使用。我们希望遵循创建FLAG-Me Vision的类似步骤，创建更多的FLAG-Me软件以及患者和药房资源。最后，我们将进行测试，看看我们开发的解决方案是否能帮助老年人在服用药物时感到更安全，并对提供的任何反馈做出回应。

An estimated 237 million medication errors every year in England, causing or contributing to 1,700 deaths and costing the NHS £98 million (Elliot et al., 2021). Errors can include people taking the wrong medicines, having an adverse reaction to a medication, or taking too much or too little. The Global Patient Safety Challenge on Medication Safety seeks to 'reduce severe, avoidable medication-related harm by 50%' by 2023 by making improvements at each stage of the medication process, including prescribing, dispensing, administering, monitoring and use (WHO, 2017).Certain groups are at increased risk of these errors, and older people are at higher risk as they are more likely to have multiple health conditions and be taking multiple medications. A report from Age UK estimated that almost two million people over 65 are likely to be taking at least seven prescribed medicines, and that this may lead to older people experiencing avoidable harm (NHS Digital, 2016). This situation occurs not only in England, but worldwide. Between 2015 and 2050, the proportion of the world's population over 60 years will nearly double from 12% to 22% (WHO, 2022). Our group has worked previously with people with sight impairments (who are at increased risk of medication errors) and community pharmacists to develop Find Logo And Give MEdication advice (FLAG-Me) Vision software. Our solution lets pharmacists know if a person has a sight impairment and allows them to offer patients a 1:1 consultation. Strategies and resources from our website can then be tailored to patient need. These may include ways to help tell the difference between medications, ways to find out what is on medication labels and safety information on medication information leaflets. FLAG-Me Vision is one solution to finding people at high risk of medication errors and alerting the pharmacist to the fact that they may need additional support around their medication in order to avoid medication-related harm.We know other conditions may also play an important part in medication errors. We will speak to older people about the problems experienced around their medication at focus groups and sort these according to specific health conditions. Hearing problems may mean that information from the doctor or nurse maybe missed, or that memory issues mean people simply forget to take medication as prescribed or alternatively may take too much or medication that is not theirs.From this, we plan to co-produce further FLAG-Me solutions, with input from older people throughout the project to make sure anything we produced meets their needs and can also be used by community pharmacists. We expect to follow similar steps used to create FLAG-Me Vision, to create additional FLAG-Me software and patient and pharmacy resources.Finally, we will carry out tests to see if our developed solutions help older people feel more safe when taking their medication and respond to any feedback provided.