Personal Electronic Records of Medications (PERMs) for medication reconciliation at care transitions: a rapid realist review
Abstract Background Medication reconciliation (MedRec), a process to reduce medication error at care transitions, is labour- and resource-intensive and time-consuming. Use of Personal Electronic Records of Medications (PERMs) in health information systems to support MedRec have proven challenging. R...
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| Format: | Article |
| Language: | English |
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BMC
2021-11-01
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| Series: | BMC Medical Informatics and Decision Making |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12911-021-01659-8 |
| _version_ | 1818823264123748352 |
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| author | Catherine Waldron Joan Cahill Sam Cromie Tim Delaney Sean P. Kennelly Joshua M. Pevnick Tamasine Grimes |
| author_facet | Catherine Waldron Joan Cahill Sam Cromie Tim Delaney Sean P. Kennelly Joshua M. Pevnick Tamasine Grimes |
| author_sort | Catherine Waldron |
| collection | DOAJ |
| description | Abstract Background Medication reconciliation (MedRec), a process to reduce medication error at care transitions, is labour- and resource-intensive and time-consuming. Use of Personal Electronic Records of Medications (PERMs) in health information systems to support MedRec have proven challenging. Relatively little is known about the design, use or implementation of PERMs at care transitions that impacts on MedRec in the ‘real world’. To respond to this gap in knowledge we undertook a rapid realist review (RRR). The aim was to develop theories to explain how, why, when, where and for whom PERMs are designed, implemented or used in practice at care transitions that impacts on MedRec. Methodology We used realist methodology and undertook the RRR between August 2020 and February 2021. We collaborated with experts in the field to identify key themes. Articles were sourced from four databases (Pubmed, Embase, CINAHL Complete and OpenGrey) to contribute to the theory development. Quality assessment, screening and data extraction using NVivo was completed. Contexts, mechanisms and outcomes configurations were identified and synthesised. The experts considered these theories for relevance and practicality and suggested refinements. Results Ten provisional theories were identified from 19 articles. Some theories relate to the design (T2 Inclusive design, T3 PERMs complement existing good processes, T7 Interoperability), some relate to the implementation (T5 Tailored training, T9 Positive impact of legislation or governance), some relate to use (T6 Support and on-demand training) and others relate iteratively to all stages of the process (T1 Engage stakeholders, T4 Build trust, T8 Resource investment, T10 Patients as users of PERMs). Conclusions This RRR has allowed additional valuable data to be extracted from existing primary research, with minimal resources, that may impact positively on future developments in this area. The theories are interdependent to a greater or lesser extent; several or all of the theories may need to be in play to collectively impact on the design, implementation or use of PERMs for MedRec at care transitions. These theories should now be incorporated into an intervention and evaluated to further test their validity. |
| first_indexed | 2024-12-18T23:37:13Z |
| format | Article |
| id | doaj.art-1ed4d0d7d6394ae29bc40fdb3768794a |
| institution | Directory Open Access Journal |
| issn | 1472-6947 |
| language | English |
| last_indexed | 2024-12-18T23:37:13Z |
| publishDate | 2021-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Informatics and Decision Making |
| spelling | doaj.art-1ed4d0d7d6394ae29bc40fdb3768794a2022-12-21T20:47:29ZengBMCBMC Medical Informatics and Decision Making1472-69472021-11-0121111710.1186/s12911-021-01659-8Personal Electronic Records of Medications (PERMs) for medication reconciliation at care transitions: a rapid realist reviewCatherine Waldron0Joan Cahill1Sam Cromie2Tim Delaney3Sean P. Kennelly4Joshua M. Pevnick5Tamasine Grimes6School of Pharmacy and Pharmaceutical Sciences, Trinity College DublinCentre for Innovative Human Systems & School of Psychology, Trinity College DublinCentre for Innovative Human Systems & School of Psychology, Trinity College DublinPharmacy Department, Tallaght University HospitalDepartment of Medical Gerontology, Trinity College DublinCedars-Sinai Medical CenterSchool of Pharmacy and Pharmaceutical Sciences, Trinity College DublinAbstract Background Medication reconciliation (MedRec), a process to reduce medication error at care transitions, is labour- and resource-intensive and time-consuming. Use of Personal Electronic Records of Medications (PERMs) in health information systems to support MedRec have proven challenging. Relatively little is known about the design, use or implementation of PERMs at care transitions that impacts on MedRec in the ‘real world’. To respond to this gap in knowledge we undertook a rapid realist review (RRR). The aim was to develop theories to explain how, why, when, where and for whom PERMs are designed, implemented or used in practice at care transitions that impacts on MedRec. Methodology We used realist methodology and undertook the RRR between August 2020 and February 2021. We collaborated with experts in the field to identify key themes. Articles were sourced from four databases (Pubmed, Embase, CINAHL Complete and OpenGrey) to contribute to the theory development. Quality assessment, screening and data extraction using NVivo was completed. Contexts, mechanisms and outcomes configurations were identified and synthesised. The experts considered these theories for relevance and practicality and suggested refinements. Results Ten provisional theories were identified from 19 articles. Some theories relate to the design (T2 Inclusive design, T3 PERMs complement existing good processes, T7 Interoperability), some relate to the implementation (T5 Tailored training, T9 Positive impact of legislation or governance), some relate to use (T6 Support and on-demand training) and others relate iteratively to all stages of the process (T1 Engage stakeholders, T4 Build trust, T8 Resource investment, T10 Patients as users of PERMs). Conclusions This RRR has allowed additional valuable data to be extracted from existing primary research, with minimal resources, that may impact positively on future developments in this area. The theories are interdependent to a greater or lesser extent; several or all of the theories may need to be in play to collectively impact on the design, implementation or use of PERMs for MedRec at care transitions. These theories should now be incorporated into an intervention and evaluated to further test their validity.https://doi.org/10.1186/s12911-021-01659-8Medication reconciliationCare transitionsRealist reviewElectronic health records |
| spellingShingle | Catherine Waldron Joan Cahill Sam Cromie Tim Delaney Sean P. Kennelly Joshua M. Pevnick Tamasine Grimes Personal Electronic Records of Medications (PERMs) for medication reconciliation at care transitions: a rapid realist review BMC Medical Informatics and Decision Making Medication reconciliation Care transitions Realist review Electronic health records |
| title | Personal Electronic Records of Medications (PERMs) for medication reconciliation at care transitions: a rapid realist review |
| title_full | Personal Electronic Records of Medications (PERMs) for medication reconciliation at care transitions: a rapid realist review |
| title_fullStr | Personal Electronic Records of Medications (PERMs) for medication reconciliation at care transitions: a rapid realist review |
| title_full_unstemmed | Personal Electronic Records of Medications (PERMs) for medication reconciliation at care transitions: a rapid realist review |
| title_short | Personal Electronic Records of Medications (PERMs) for medication reconciliation at care transitions: a rapid realist review |
| title_sort | personal electronic records of medications perms for medication reconciliation at care transitions a rapid realist review |
| topic | Medication reconciliation Care transitions Realist review Electronic health records |
| url | https://doi.org/10.1186/s12911-021-01659-8 |
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