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 (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.

Public Health Relevance

Patients and their families often have difficulty managing medications, especially across transitions of care. For frail elderly patients, medication errors in prescribing and use can result in harm and need for rehospitalization. With this project, we propose to add a medication manager tool to our existing private social network for patients and their families and thereby to improve medication management and safety. This research will help us to learn more about the adoption of online tools and networks, and how these tools affect patient engagement and medication safety.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Demonstration and Dissemination Projects (R18)
Project #
1R18HS024869-01
Application #
9209495
Study Section
Healthcare Patient Safety and Quality Improvement Research (HSQR)
Program Officer
Perfetto, Deborah
Project Start
2016-09-30
Project End
2019-08-31
Budget Start
2016-09-30
Budget End
2017-08-31
Support Year
1
Fiscal Year
2016
Total Cost
Indirect Cost
Name
Beth Israel Deaconess Medical Center
Department
Type
DUNS #
071723621
City
Boston
State
MA
Country
United States
Zip Code
02215