Empowering people to help speak up about safety in primary care: Using codesign to involve patients and professionals in developing new interventions for patients with multimorbidity

Knowles, Sarah; Hays, Rebecca; Senra, Hugo; Bower, Peter; Locock, Louise; Protheroe, Jo; Sanders, Caroline; Daker-White, Gavin

Abstract

Background
Multimorbidity, defined as the presence of two or more long-term conditions, is increasingly common in primary care, and patients with multimorbidity may face particular barriers to quality of care and increased safety risks due to the complexity of managing multiple conditions. Consistent with calls to directly involve service users in improving care, we aimed to use design materials to codesign new interventions to improve safety in primary care.

Design
We drew on two established methodsaccelerated experience-based codesign and the future workshop approach. We synthesized design materials based on research into the patient experience of safety and multimorbidity in primary care to enable both patients, service users and carers, and primary health-care professionals to propose interventions to improve care.

Results
Both patients and professionals prioritized polypharmacy as a threat to safety. Their recommendations for supportive interventions were consistent with Burden of Treatment theory, emphasizing the limited capacity of patients with multimorbidity and the need for services to proactively offer support to reduce the burden of managing complex treatment regimes.

Discussion & Conclusions
The process was feasible and acceptable to participants, who valued the opportunity to jointly propose new interventions. The iterative workshop approach enabled the research team to better explore and refine the suggestions of attendees. Final recommendations included the need for accessible reminders to support medication adherence and medication reviews for particularly vulnerable patients conducted with pharmacists within GP practices.

Citation

Knowles, S., Hays, R., Senra, H., Bower, P., Locock, L., Protheroe, J., …Daker-White, G. (2018). Empowering people to help speak up about safety in primary care: Using codesign to involve patients and professionals in developing new interventions for patients with multimorbidity. Health Expectations, 21(2), 539-548. https://doi.org/10.1111/hex.12648

• Journal Article Type: Article
• Acceptance Date: Oct 17, 2017
• Online Publication Date: Mar 25, 2018
• Publication Date: 2018-04
• Journal: Health Expectations
• Print ISSN: 1369-6513
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 21
• Issue: 2
• Pages: 539-548
• DOI: https://doi.org/10.1111/hex.12648
• Keywords: coproduction, long-term conditions, patient involvement, patient safety, polypharmacy, primary care
• Publisher URL: https://doi.org/10.1111/hex.12648