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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Autores principales:	Catherine Waldron, Joan Cahill, Sam Cromie, Tim Delaney, Sean P. Kennelly, Joshua M. Pevnick, Tamasine Grimes
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Medication reconciliation Care transitions Realist review Electronic health records Computer applications to medicine. Medical informatics R858-859.7
Acceso en línea:	https://doaj.org/article/1ed4d0d7d6394ae29bc40fdb3768794a
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spelling	oai:doaj.org-article:1ed4d0d7d6394ae29bc40fdb3768794a2021-11-08T10:59:24ZPersonal Electronic Records of Medications (PERMs) for medication reconciliation at care transitions: a rapid realist review10.1186/s12911-021-01659-81472-6947https://doaj.org/article/1ed4d0d7d6394ae29bc40fdb3768794a2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12911-021-01659-8https://doaj.org/toc/1472-6947Abstract 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.Catherine WaldronJoan CahillSam CromieTim DelaneySean P. KennellyJoshua M. PevnickTamasine GrimesBMCarticleMedication reconciliationCare transitionsRealist reviewElectronic health recordsComputer applications to medicine. Medical informaticsR858-859.7ENBMC Medical Informatics and Decision Making, Vol 21, Iss 1, Pp 1-17 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medication reconciliation Care transitions Realist review Electronic health records Computer applications to medicine. Medical informatics R858-859.7
spellingShingle	Medication reconciliation Care transitions Realist review Electronic health records Computer applications to medicine. Medical informatics R858-859.7 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
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.
format	article
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
title	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_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_sort	personal electronic records of medications (perms) for medication reconciliation at care transitions: a rapid realist review
publisher	BMC
publishDate	2021
url	https://doaj.org/article/1ed4d0d7d6394ae29bc40fdb3768794a
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Personal Electronic Records of Medications (PERMs) for medication reconciliation at care transitions: a rapid realist review

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