Get involved: Know Check Ask campaign for people working in healthcare

Safe med

 

Welcome! Healthcare professionals have an important role in helping to ensure medication safety.  An important part of this is engaging with people and discussing their medicines with them.  This may involve helping people to:

 

Know: about each of their medicines and encouraging them to keep an up-to-date medicines list.

Check: they know how to use their medicines correctly.

Ask: discussing medicines with the person taking them and answering any questions they may have.

  

 We’ve included some information below to help you in this work:

 

  • Background information
  • Why is this work important?
  • What is the My medicines list?
  • Where can people access copies of the My medicines list?
  • What can I do as a healthcare professional?
  • Is a medicines list reliable?
  • What are the Five moments for medication safety?
  • My medicines list and adherence to medication
  • Key messages you can share with people who take regular medicines

 

 

Background information

The HSE is launching a medication safety campaign which has been developed in line with the World Health Organisation (WHO) Global Patient Safety Challenge Medication without Harm. The aim of the WHO challenge is to reduce severe avoidable harm by 50% globally over the next 5 years. As in previous WHO campaigns, such as Clean Care is Safer Care, which focused on hand hygiene, there is public awareness component to the programme.

The call for action of the campaign is Know Check Ask. The aim of the campaign is to encourage those taking medication and their caregivers to take an active role in managing their medication.

  

Why is this work important?

Adverse Drug Events are the 3rd most common type of adverse events in the Irish Healthcare System 1 with 8.8% of emergency admissions being drugs related 2.

Safe prescribing at transitions of care can be particularly problematic. With traditional medication history taking, Irish research has shown that:

  • 41% of patients had at least one medication error or omission at admission to hospital 3
  • 56% of patients experienced prescribing errors and mis-communication at the time of discharge 4

People who use a memory aid, such as medicines list, are more likely to be able to recall their medicines accurately than those who do not 5.

 

 

What is the My medicines list?

The My medicines list is a list of key information about a person's medicines.

We are encouraging everyone who takes regular medicines to keep an up-to-date list of the current medication and to take this with them to all healthcare appointments.

The Medication Safety Programme Improvement "Safermeds", as part of the HSE National Quality Improvement Team, has developed a My Medicines List. This is based on work previously undertaken in Tallaght University Hospital.

This photo is a sample of My medicines list:

My medicines leaflet pic

 

Where can people access copies of the My medicines list?

People who take medicines can complete their own list or can do so with help from a caregiver.

Copies of the My medicines list are available:

  • from community pharmacies from July 2019
  • to download by clicking here

Another option for people taking regular medicines is to ask their pharmacist or GP to print a copy of their current medication for them. The most appropriate approach will depend on the individual.

 

What can I do as a healthcare professional?

As a healthcare professional, engage with people as part of the Know Check Ask campaign: 

  • Encourage people on medication to keep an up-to-date list of their medicines and explain why it can be helpful. Suggest keeping a photo of the list.
  • Ask "Do you have your medicines list with you?" Refer to the person's list when discussing medication, particularly, out-patient appointments and at transitions of care. If needed, take a copy of the list but return the original to the individual.
  • Ask the person if anyone helps them with them with their medicines at home and if they would like for that person to be involved in discussion about their medicines.
  • Consider how you could promote this campaign in your place of work.
  • See the information below in Key messages you can share with people who take regular medicines.

If you can not answer all of a person's questions about their medication, refer them to someone who can help answer the query, or to appropriate sources of written information.

 

Is a medicines list reliable?

People who use a memory aid, such as a medicines list, could recall their medicines accurately (65%) than those who did not (21%), providing a more reliable initial medication history.5

You may still need to verify a person's medicines list with an additional reliable source of information as no single source is complete for everyone. Options include:

  • contacting the community pharmacy or contacting the GP practice which are complete for 77% and 69% of people respectively.5
  • if there are any differences, return to clarify these with the patient.

 

What are the "Five moments for medication safety"?

The five moments for medication safety are key moments when an individual can check they are getting the most out of their medicines.

An App is available to guide people through the 5 moments for medication safety and is available free of charge via the App Store and on Google Play.  Search for “WHO Medsafe”.

Watch a short clip below:

  

 

  

Starting a medicine

Taking my medicine

Adding a medicine

Reviewing my medicine

Stopping my medicine

My medicines list and adherence to medication

Adherence to medication averages 50% with approximately half of this unintentional in multiple studies.

Medication lists have been shown to increase adherence, knowledge and responsibility, and increase self- management. Involving the person taking the medication in completing the list is a key part of its success.

The use of a medication list or log is widely recommended by multiple organisations and health systems as part of interventions to improve a person's adherence.

The Know Check Ask campaign including a medication list, and better communication has the potential to overcome many of the most challenging barriers to self-management and adherence:

  • Lack of knowledge about medication and its use as part of the “Check” and “Ask” components of the message
    • Encourages people to read­ medicine instructions and patient information leaflets
    • Asking a healthcare professional if unsure promotes communication and discussion.
  • Medication complexity       
    • List provides a reference to clarify instructions, in daily use and at appointment
    • Healthcare professionals can become aware of any misinterpretation of instructions when reviewing the list.  This can prompt communication to      help understanding.
  • Forgetfulness
    •      List acts as a reminder in daily use and at appointments
  • Intentional non-adherence due to regimen complexity, cost, real or perceived adverse effects and beliefs, and knowledge about medication
    •       “Ask” can prompt communication, aided by the list and involve both parties in trying to improve the regimen to help the person with their particular regimen
       

Key messages you can share with people who take regular medicines

Many people do not realise how helpful an up to date medicines list can be both to themselves and also to healthcare staff. Please select to see the key messages which you can share with people who use regular medicines.

 

See our section Resources for information to help promote this campaign locally.

  

References


1.      Rafter N, Hickey A, Conroy RM, et al The Irish National Adverse Events Study (INAES) BMJ Qual Saf 2017;26:111-119.
2.      Ahern F, Sahm LJ, Lynch D, et al. Emerg Med J doi:10.1136/ emermed-2012-201945
3.      Grimes TC, Deasy E, Allen A, et al. BMJ Qual Saf  doi:10.1136/bmjqs-2013002188
4.      O’Riordan C, Grimes TC, Delaney T Int J Clin Pharm DOI 10.1007/s11096-016-0349-7
5.      Fitzsimons M, Grimes T, Galvin M. Int J Pharm Practice 2011; 19: 408–416

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