Participatory research to improve medication reconciliation for older adults in the community.

Doucette, Lorna; Kiely, Bridget T; Gierisch, Jennifer M; Marion, Eve; Nadler, Lisa; Heflin, Mitchell T; Upchurch, Gina

Participatory research to improve medication reconciliation for older adults in the community.

dc.contributor.author	Doucette, Lorna
dc.contributor.author	Kiely, Bridget T
dc.contributor.author	Gierisch, Jennifer M
dc.contributor.author	Marion, Eve
dc.contributor.author	Nadler, Lisa
dc.contributor.author	Heflin, Mitchell T
dc.contributor.author	Upchurch, Gina
dc.date.accessioned	2023-10-12T17:24:05Z
dc.date.available	2023-10-12T17:24:05Z
dc.date.issued	2023-02
dc.date.updated	2023-10-12T17:24:05Z
dc.description.abstract	Introduction Medication reconciliation, a technique that assists in aligning a care team's understanding of an individual's true medication regimen, is vital to optimize medication use and prevent medication errors. Historically, most medication reconciliation research has focused on institutional settings and transitional care, with comparatively little attention given to medication reconciliation in community settings. To optimize medication reconciliation for community-dwelling older adults, healthcare professionals and older adults must be engaged in co-designing processes that create sustainable approaches. Methods Academic researchers, older adults, and community- and health system-based healthcare professionals engaged in a participatory process to better understand medication reconciliation barriers and co-design solutions. The initiative consisted of two participatory research approaches: (1) Sparks Innovation Studios, which synthesized professional expertise and opinions, and (2) a Community Consultation Studio with older adults. Input from both groups informed a list of possible solutions and these were ranked based on evaluative criteria of feasibility, person-centeredness, equity, and sustainability. Results Sparks Innovation Studios identified a lack of ownership, fragmented healthcare systems, and time constraints as the leading barriers to medication reconciliation. The Community Consultation Studio revealed that older adults often feel dismissed in medical encounters and perceive poor communication with and among providers. The Community Consultation Studio and Sparks Innovation Studios resulted in four highly-ranked solutions to improve medication reconciliation: (1) support for older adults to improve health literacy and ownership; (2) ensuring medication indications are included on prescription labels; (3) trainings and incentives for front-line staff in clinic settings to become champions for medication reconciliation; and (4) electronic health record improvements that simplify active medication lists. Conclusion Engaging community representatives with academic partners in the research process enhanced understanding of community priorities and provided a practical roadmap for innovations that have the potential to improve the well-being of community-dwelling older adults.
dc.identifier.issn	0002-8614
dc.identifier.issn	1532-5415
dc.identifier.uri	https://hdl.handle.net/10161/29268
dc.language	eng
dc.publisher	Wiley
dc.relation.ispartof	Journal of the American Geriatrics Society
dc.relation.isversionof	10.1111/jgs.18132
dc.subject	Humans
dc.subject	Medication Errors
dc.subject	Aged
dc.subject	Health Personnel
dc.subject	Community-Based Participatory Research
dc.subject	Medication Reconciliation
dc.subject	Transitional Care
dc.title	Participatory research to improve medication reconciliation for older adults in the community.
dc.type	Journal article
duke.contributor.orcid	Marion, Eve\|0000-0002-8559-640X
pubs.begin-page	620
pubs.end-page	631
pubs.issue	2
pubs.organisational-group	Duke
pubs.organisational-group	School of Medicine
pubs.organisational-group	School of Nursing
pubs.organisational-group	Staff
pubs.organisational-group	Nursing
pubs.organisational-group	Basic Science Departments
pubs.organisational-group	Clinical Science Departments
pubs.organisational-group	Institutes and Centers
pubs.organisational-group	Medicine
pubs.organisational-group	Medicine, General Internal Medicine
pubs.organisational-group	Medicine, Geriatrics
pubs.organisational-group	Duke Cancer Institute
pubs.organisational-group	Center for the Study of Aging and Human Development
pubs.organisational-group	Population Health Sciences
pubs.publication-status	Published
pubs.volume	71