Implementation and sustainability study of a patient’s own medications management policy in the hospital using the RE-AIM framework
Objective The main objective was to develop a policy for the management of patients’ own medications (POM) in a tertiary university hospital and to evaluate the outcomes of its implementation. The secondary objective was to explore the effects of introducing a policy on the incidence and severity of...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2025-05-01
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| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/14/2/e003072.full |
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| author | Christophe Lelubre Sophie Lorent Camille Hoornaert Stéphanie Pochet Larissa Zubryckyj |
| author_facet | Christophe Lelubre Sophie Lorent Camille Hoornaert Stéphanie Pochet Larissa Zubryckyj |
| author_sort | Christophe Lelubre |
| collection | DOAJ |
| description | Objective The main objective was to develop a policy for the management of patients’ own medications (POM) in a tertiary university hospital and to evaluate the outcomes of its implementation. The secondary objective was to explore the effects of introducing a policy on the incidence and severity of drug-related problems (DRPs).Methods The implementation evaluation was based on the mixed method using the RE-AIM model (reach, effectiveness, adoption, implementation and maintenance). Each POM was analysed to identify the cause and severity of the DRP (pre-implementation and after 1 week, 3 months and 1 year). Three months after the implementation, an interview with hospital providers explored barriers and facilitators of the POM management policy as well as factors impacting the programme’s sustainability.Results 205 patients were included pre-implementation, and over the three post-implementation periods, a total of 586 additional patients were included in the quantitative study. 17 interviews were conducted. Approximately 60% of the included patients brought their POM to the hospital during each period (reach). There was a statistically significant decrease in the percentage of POM self-administered (p<0.001), the percentage of POM used by nurses to administer doses (p<0.001), the rate (p=0.005) and severity (p=0.008) of DRP when compared with the situation before and after 1 week and 3 months of policy implementation (effectiveness, implementation). The rate (p=0.074) and severity (p=0.062) of DRP decrease after 1 year of policy implementation was not significant (maintenance).Conclusions This study presents a POM management policy and highlights the unique challenges of implementing and, in particular, maintaining it in the hospital setting. A POM management policy reduces the incidence and severity of DRP caused by POM if the policy is fully communicated and staff are appropriately trained. |
| format | Article |
| id | doaj-art-d28bb09fba1248c39e5c97a66c058a94 |
| institution | OA Journals |
| issn | 2399-6641 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Quality |
| spelling | doaj-art-d28bb09fba1248c39e5c97a66c058a942025-08-20T01:52:18ZengBMJ Publishing GroupBMJ Open Quality2399-66412025-05-0114210.1136/bmjoq-2024-003072Implementation and sustainability study of a patient’s own medications management policy in the hospital using the RE-AIM frameworkChristophe Lelubre0Sophie Lorent1Camille Hoornaert2Stéphanie Pochet3Larissa Zubryckyj4Internal Medicine, Université de Mons, Mons, BelgiumPharmacy Department, Hopital Erasme, Bruxelles, BelgiumPharmacotherapy and Pharmaceutics, Université Libre de Bruxelles Faculté de Pharmacie, Bruxelles, BelgiumPharmacotherapy and Pharmaceutics, Université Libre de Bruxelles Faculté de Pharmacie, Bruxelles, BelgiumPharmacy Department, Hopital Erasme, Bruxelles, BelgiumObjective The main objective was to develop a policy for the management of patients’ own medications (POM) in a tertiary university hospital and to evaluate the outcomes of its implementation. The secondary objective was to explore the effects of introducing a policy on the incidence and severity of drug-related problems (DRPs).Methods The implementation evaluation was based on the mixed method using the RE-AIM model (reach, effectiveness, adoption, implementation and maintenance). Each POM was analysed to identify the cause and severity of the DRP (pre-implementation and after 1 week, 3 months and 1 year). Three months after the implementation, an interview with hospital providers explored barriers and facilitators of the POM management policy as well as factors impacting the programme’s sustainability.Results 205 patients were included pre-implementation, and over the three post-implementation periods, a total of 586 additional patients were included in the quantitative study. 17 interviews were conducted. Approximately 60% of the included patients brought their POM to the hospital during each period (reach). There was a statistically significant decrease in the percentage of POM self-administered (p<0.001), the percentage of POM used by nurses to administer doses (p<0.001), the rate (p=0.005) and severity (p=0.008) of DRP when compared with the situation before and after 1 week and 3 months of policy implementation (effectiveness, implementation). The rate (p=0.074) and severity (p=0.062) of DRP decrease after 1 year of policy implementation was not significant (maintenance).Conclusions This study presents a POM management policy and highlights the unique challenges of implementing and, in particular, maintaining it in the hospital setting. A POM management policy reduces the incidence and severity of DRP caused by POM if the policy is fully communicated and staff are appropriately trained.https://bmjopenquality.bmj.com/content/14/2/e003072.full |
| spellingShingle | Christophe Lelubre Sophie Lorent Camille Hoornaert Stéphanie Pochet Larissa Zubryckyj Implementation and sustainability study of a patient’s own medications management policy in the hospital using the RE-AIM framework BMJ Open Quality |
| title | Implementation and sustainability study of a patient’s own medications management policy in the hospital using the RE-AIM framework |
| title_full | Implementation and sustainability study of a patient’s own medications management policy in the hospital using the RE-AIM framework |
| title_fullStr | Implementation and sustainability study of a patient’s own medications management policy in the hospital using the RE-AIM framework |
| title_full_unstemmed | Implementation and sustainability study of a patient’s own medications management policy in the hospital using the RE-AIM framework |
| title_short | Implementation and sustainability study of a patient’s own medications management policy in the hospital using the RE-AIM framework |
| title_sort | implementation and sustainability study of a patient s own medications management policy in the hospital using the re aim framework |
| url | https://bmjopenquality.bmj.com/content/14/2/e003072.full |
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