Citizen Empowerment and Patient Involvement

• How does public education affect polymedication and related therapy outcomes?

  Half of all patients who take four or more drugs are known not to take them as prescribed, with resulting harm. Non-adherence to prescribed medicines is a major public health issue as it is intricately related to multimorbidity and polypharmacy. Public education might vary from one country to another, with places where public education is indeed insufficient and others where good examples of practices can be found. Educating citizens and raising patient awareness about the problems of polypharmacy and non-adherence are essential to prevent harm from medicine-related side effects and to improve healthcare systems and controlled polymedication. Equally important is aiding clinicians by providing patients with a robust, evidence-based, patient-centred, and holistic medication review system.

  References
  1. Mair A, Fernandez-Llimos F, Alonso A, Harrison C, Hurding S, Kempen T, Kinnear M, Michael N, McIntosh J, Wilson M, The Simpathy consortium. Polypharmacy Management by 2030: a patient safety challenge, 2nd edition. Coimbra: SIMPATHY Consortium; 2017
  2. Barnett NL, Oboh L, Smith K. Patient-centred management of polypharmacy: a process for practice. Eur J Hosp Pharm. 2016 Mar;23(2):113-117. doi: 10.1136/ejhpharm-2015-000762. Epub 2015 Dec 23. PMID: 31156827; PMCID: PMC6451546.

• What do empowerment approaches in clinical practices look like?

  Finding the balance between aggressively treating diseases and avoiding medication‐related harm is challenging for healthcare professionals. Much progress has been made in achieving appropriate polypharmacy, including the process of deprescribing. However, empowering patients and their carers to be involved in the medication review and decision-making process can further help manage polypharmacy. From the patient perspective, it is important to address their needs adequately. Therefore, patients need to be provided with extensive information and be enabled to ask questions. In this way, they can improve their understanding of how best to make decisions regarding the management of their long-term conditions. Information provision within patient management in clinical practices should be consistent across all parts of the healthcare system to achieve a significant improvement. Hence, empowering clinical leaders within their departments to take the lead on implementation and gain support from the hospital is also essential.

  References
  1. Mair A, Fernandez-Llimos F, Alonso A, Harrison C, Hurding S, Kempen T, Kinnear M, Michael N, McIntosh J, Wilson M, The Simpathy consortium. Polypharmacy Management by 2030: a patient safety challenge, 2nd edition. Coimbra: SIMPATHY Consortium; 2017
  2. Barnett NL, Oboh L, Smith K. Patient-centred management of polypharmacy: a process for practice. Eur J Hosp Pharm. 2016 Mar;23(2):113-117. doi: 10.1136/ejhpharm-2015-000762. Epub 2015 Dec 23. PMID: 31156827; PMCID: PMC6451546.

• How do patient participation and patient involvement improve safety in polymedication?

  Within the need for patient empowerment in polymedication, patients need to hold a record of their medication and share it at each care visit to allow clinicians to consider the impact of additional medication or stopping treatment. Such a record can be either on paper or electronic to be accessible for patients of all ages in low- and middle-income countries as well. Patients should have access to mobile apps and tools that help them understand appropriate polypharmacy and enable them to be active participants in medication reviews. Patient management must ensure that patients take an integral part in decisions made about their medication and that they are empowered to do so. Considering policy-making processes, it is also important to include the patient view when designing public services to ensure a focus on patient empowerment and centredness.

• How will the SafePolyMed project involve patients?

  Patients are active partners in the SafePolyMed project to ensure that the patient perspective is embedded in all processes following an all-encompassing patient-centred approach. In light of the importance of public education in polypharmacy, the SafePolyMed project will provide training for patient organisations and experts. Such training is needed to tackle essential aspects of patient and public education in the relevant areas of public health, policy, polypharmacy, and pharmacovigilance in which patients need to be empowered.