Prescribed medicines with risk of dependence: Improving patient care
Research type
Research Study
Full title
Improving the quality and experience of care for patients prescribed medicines with a risk of dependence or withdrawal
IRAS ID
295712
Contact name
Jennifer Seddon
Contact email
Sponsor organisation
University of Bedfordshire
Duration of Study in the UK
1 years, 5 months, 31 days
Research summary
Summary of Research
A recent review by Public Health England (2019) found that 11.5 million people, equivalent to 26% of the adult population, were prescribed medications with a risk of dependence or withdrawal in 2017/2018. Public Health England acknowledges that patients prescribed these medications do not always receive appropriate care and has called for further research.This 18-month NIHR-funded study aims to improve the quality and experience of care for patients prescribed benzodiazepines, Z-drugs, antidepressants, opioids and gabapentinoids/ pregabalin. The study will bring together patients and healthcare staff to i) develop understanding of current patient and staff experience, ii) identify strategies and priorities to improve the experience and quality of care, and iii) design and implement change to improve the quality and experience of care.
The study will use Experienced Based Co-Design (EBCD), a form of participatory action research that has been designed for and within the NHS to improve treatment and care. We will work with at least three GP practices to recruit and interview 20 patients and 15 health professionals. Patient interviews will focus on key phases of the patient journey; staff interviews will explore what is and isn’t working well from their perspective. Patient interviews will be used to create a 30- minute ‘trigger film’ which will highlight the key emotional moments throughout the patient journey. Using the findings and the patient film we will hold feedback events for staff and patients to identify key areas for improvement. A co-design team of both staff and patients will then be established to design and implement solutions.
We anticipate that this study will contribute to improved patient experience and a reduction in harm associated with medication dependence, withdrawal and the adverse effects of long-term use.
Summary of Results
This study aimed to improve the quality and experience of care for patients prescribed benzodiazepines, z-drugs, antidepressants, opioids and gabapentinoids. These medications are prescribed to millions of people each year in the UK. Public Health England has acknowledged that people prescribed these medications do not always receive appropriate care.Method: The study used Experience Based Co-Design, a form of participatory action research. Twenty patients and fifteen healthcare professionals were recruited from five GP practices and interviewed using semi-structured methods. Patient interviews were used to create a 30-minute ‘trigger film’ which highlighted key emotional moments of the patient journey. This film was shown to patients and healthcare staff to trigger further dialogue on priorities for improvement. Patients and healthcare staff then worked together over a series of feedback and co-design events to identify priorities for improvement and to co-design solutions to improve the experience of care.
Results: Patients and healthcare staff identified three main improvement priorities: i) improved information and communication, ii) improved continuity of care, and iii) alternatives to medication. Solutions to improve care were co-designed by patients and healthcare staff. Improvement initiatives were implemented within participating GP practices to improve the patient experience of care.
Conclusion: This study highlights how clinical practice can be changed to improve the experience of care for patients prescribed medication with a risk of dependence or withdrawal. Co-designing improvement initiatives with patients and healthcare staff resulted in solutions that addressed real need and were more likely to be implemented.
REC name
East Midlands - Leicester Central Research Ethics Committee
REC reference
21/EM/0116
Date of REC Opinion
3 Jun 2021
REC opinion
Further Information Favourable Opinion