Patient Engagement in Reporting Medication Events during Transitions of Care

Abstract: Transitions of care (TOC) for patients with cancer are complex situations that increase risks for poor patient outcomes and adverse events. Our proposal is built on the Chronic Care Model evidence that informed, activated patients could provide meaningful feedback on their experiences and perceptions of safety in the context of care transitions, promoting productive interactions through timely responses and support toward improved outcomes. To leverage self-management via the support of information technology systems, we propose a consumer- oriented patient safety event (PSE) platform to engage patients with cancer and their families to report medication adverse events during TOC and improve the understanding of the nature and causes of PSE. Despite the feasibility of consumer-oriented PSE reporting has been established, it remains largely unknown how to engage patients and families in using the reporting systems, especially how to mitigate the identified barriers such as patient factors, insufficient system design features, and mismatch between technology platform and objectives for patients and families to involve in PSE reporting during TOC. We chose the priority population who are under the treatment of oral anticancer agents (OAA) at home since they face specific medication safety and self- management challenges, including complex regimens and life-threatening toxicities, as well as high potentials for drug-drug and drug-food interactions. Application of the PSE reporting system is innovative in the OAA management process, which will improve care transitions by enhancing patient communication and care coordination, thereby reducing and mitigating adverse events. The platform built upon the AHRQ common formats is expected to defragment information and utilize community resources regarding OAA adverse events and self-management, interoperable with prevailing event reporting systems, and compatible with federal data sources in aggregating, trending events via patient safety organizations. Our approach based on rigorous theoretical frameworks for improving patient engagement is scalable to other chronic conditions during transitions of care. This proposal is focused on supporting patient self-management activities during care transitions back home, responding to the AHRQ priority of matching the technology platform to improve the quality of care and patient outcomes.