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. 2023 Feb;71(2):620-631.
doi: 10.1111/jgs.18132. Epub 2022 Nov 24.

Participatory research to improve medication reconciliation for older adults in the community

Lorna Doucette  1   2 , Bridget T Kiely  3 , Jennifer M Gierisch  4   5   6 , Eve Marion  7   8 , Lisa Nadler  9 , Mitchell T Heflin  10   11 , Gina Upchurch  2   12   13
Affiliations

Participatory research to improve medication reconciliation for older adults in the community

Lorna Doucette et al. J Am Geriatr Soc. 2023 Feb.

Abstract

Introduction: Medication reconciliation, a technique that assists in aligning a care team's understanding of an individual's true medication regimen, is vital to optimize medication use and prevent medication errors. Historically, most medication reconciliation research has focused on institutional settings and transitional care, with comparatively little attention given to medication reconciliation in community settings. To optimize medication reconciliation for community-dwelling older adults, healthcare professionals and older adults must be engaged in co-designing processes that create sustainable approaches.

Methods: Academic researchers, older adults, and community- and health system-based healthcare professionals engaged in a participatory process to better understand medication reconciliation barriers and co-design solutions. The initiative consisted of two participatory research approaches: (1) Sparks Innovation Studios, which synthesized professional expertise and opinions, and (2) a Community Consultation Studio with older adults. Input from both groups informed a list of possible solutions and these were ranked based on evaluative criteria of feasibility, person-centeredness, equity, and sustainability.

Results: Sparks Innovation Studios identified a lack of ownership, fragmented healthcare systems, and time constraints as the leading barriers to medication reconciliation. The Community Consultation Studio revealed that older adults often feel dismissed in medical encounters and perceive poor communication with and among providers. The Community Consultation Studio and Sparks Innovation Studios resulted in four highly-ranked solutions to improve medication reconciliation: (1) support for older adults to improve health literacy and ownership; (2) ensuring medication indications are included on prescription labels; (3) trainings and incentives for front-line staff in clinic settings to become champions for medication reconciliation; and (4) electronic health record improvements that simplify active medication lists.

Conclusion: Engaging community representatives with academic partners in the research process enhanced understanding of community priorities and provided a practical roadmap for innovations that have the potential to improve the well-being of community-dwelling older adults.

Keywords: community engagement; equity; medication reconciliation; older adults; participatory research.

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Conflict of interest statement

Conflicts of Interest: The authors declare no conflicts relevant to the content of this manuscript.

Figures

Figure 1.
Figure 1.
Order of activities for the participatory research approach. Abbreviations: GWEP = Geriatric Workforce Enhancement Program; SPA = Senior PharmAssist; CERI = Community Engaged Research Initiative.
Figure 2.
Figure 2.
Barriers to and Facilitators of Medication Reconciliation. Legend: red boxes correspond to barriers; green boxes correspond to facilitators of person-centered medication reconciliation. Abbreviations: HCPs = health care professionals; EHR = electronic health record; MA = medical assistant
See this image and copyright information in PMC

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