Medication safety : exploring interventions to support vulnerable patients taking high-alert medications

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Ensuring patient safety around high-risk medications such as oral anticoagulants is a global challenge. Several patient-focused interventions have been used to support vulnerable patients such as older persons taking oral anticoagulants. However, limited research has been done to support those with limited health literacy, and those from cultural and linguistic diverse (CALD) backgrounds. Qualitative and quantitative methods were used to identify the limitations in health literacy, warfarin knowledge gaps, patient’s and carer’s needs and preferences for medicine information about oral anticoagulants. A double-sided A4 size Warfarin action Plan leaflet was developed, and feedback was obtained from patients and their carers. Several benefits of the action plan were highlighted such as its concise format and understandable content, the use of visuals and how it was interactive. The action plan also addressed the knowledge gaps of patients and carers who had been using warfarin for several years, highlighting the need for regular follow up and education. An unexpected finding was that the WAP had a positive impact on behaviour. Based on the findings from the feedback on the WAP leaflet and knowledge gaps about NOACs, web-based education materials were assessed to see if they would also have a similar benefit in terms of understandability and actionability. The majority of materials were understandable, however, were not actionable. These findings suggest that there is a need for high quality NOAC medicines information that are actionable. Overall, this thesis highlights the beneficial role of the written WAP leaflet in supporting older persons taking oral anticoagulants and their carers. The implications of this leaflet is that it could also be used for NOACs and be provided to patients and their carers in a variety of settings such as the hospital and home.
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