Development of salient medication reminders to facilitate information transfer during transition from inpatient to primary care: the Delphi process

BMJ Open. 2021 May 18;11(5):e041336. doi: 10.1136/bmjopen-2020-041336.

Abstract

Objective: Transitional care is important to successful hospital discharge. Providing patients with a clear and concise summary of medication-related information can help improve outcomes, in particular, among older adults. The present study aimed to propose a framework for the development of salient medication reminders (SMR), which include drug-related risks and precautions, using the Delphi process.

Design: Identification of potential SMR statements for 80% of medication types used by older adult patients discharged from geriatric medicine departments, followed by a Delphi survey and expert panel discussion.

Settings: Medical and geriatric departments of public hospitals in Hong Kong.

Participants: A panel of 13 geriatric medical experts.

Outcome measure: A Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree) points, scoring item relevance, importance and clarity. The minimum of 70% consensus was required for each statement to be included.

Results: The expert panel achieved consensus through the Delphi process on 80 statements for 44 medication entities. Subsequently, the SMR steering group endorsed the inclusion of these statements in the SMR to be disseminated among older adults at the time of discharge from geriatric medicine departments.

Conclusions: The Delphi process contributed to the development of SMR for older adult patients discharged from public hospitals in Hong Kong. Patient experience with and staff response to the SMR were assessed at four hospitals before implementation at all public hospitals.

Keywords: geriatric medicine; health & safety; health informatics; public health.

MeSH terms

  • Aged
  • Consensus
  • Delphi Technique
  • Hong Kong
  • Humans
  • Inpatients*
  • Patient Discharge*