Getting prescription medications right at home, in hospital and hospice: an activity theory analysis to improve patient safety and confidence in palliative care
Marie Curie Research Grant Scheme Project
Duration: 36 months
Duration: 36 months
Researcher
Dr Sarah Yardley
Lead researcher
University College London
Lay abstract
Background
People with palliative care needs use prescription medications to achieve symptom control. Daily hassles with medications are commonly reported. What happens in real lif' and the effort required to achieve effective medication management in palliative care is poorly understood.
Aims
The study will collect information from patients, carers and professionals to:
1 - Model 'real life' processes underlying medication management including:
- decision-making
- prescribing
- monitoring and supply
- use (administration)
- stopping/disposal of medications
- moving across healthcare contexts.
2- Understand challenges patients and carers face and what they do/do not do to achieve effective medicines management.
3 - Understand impact of professional practices on medicines management.
Method
Three types of context will be identified in order to recruit from home, hospital and hospice. We will develop a visual process model of how using prescription medications should work. We will then observe and explore what really happens and collect information about peoples' experiences of medicines management to develop a 'real life' model. Activity theory, which can be used to good effect in analysing healthcare processes, is being used to understand what happens, who does what, and what occurs when a patient moves across contexts.
Patient and Public Involvement (PPI)
Consultation with patients, families, friends, carers and healthcare professionals helped develop this proposal.
A PPI co-applicant is part of the team, they will:
- provide an ‘expert-by-experience’ perspective
- assist the research team to engage a wider PPI population
- co-produce study dissemination products and activities.
All participants will be invited to a dissemination event and receive the study report.
Impact
Understanding processes will help develop effective use of prescription medications. Recommendations for professionals can improve current practice. Tools will be created to help patients and carers with medication management. Further research will test ideas from this study to reduce palliative care medication risks.
