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Use of patient-held information about medication (PHIMed) to support medicines optimisation: protocol for a mixed-methods descriptive study
  1. Sara Garfield1,2,
  2. Dominic Furniss3,
  3. Fran Husson1,
  4. Margaret Turley1,
  5. Bryony Dean Franklin1,2
  1. 1 Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK
  2. 2 UCL School of Pharmacy, London, UK
  3. 3 UCLIC, University College London, London, UK
  1. Correspondence to Dr Sara Garfield; sara.garfield{at}


Introduction Risks of poor information transfer across health settings are well documented, particularly for medication. There is also increasing awareness of the importance of greater patient activation. Patients may use various types of patient-held information about medication (PHIMed) to facilitate medication transfer, which may be paper or electronic. However, it is not known how PHIMed should best be used, whether it improves patient outcomes, nor is its key ‘active ingredients’ known. Discussion with patients and carers has highlighted this as a priority for research. We aim to identify how PHIMed is used in practice, barriers and facilitators to its use and key features of PHIMed that support medicines optimisation in practice.

Methods and analysis This study will take place in Greater London, England. We will include patients with long-term conditions, carers and healthcare professionals. The study has four work packages (WPs). WP1 involves qualitative interviews with healthcare professionals (n=16) and focus groups with patients and carers (n=20), including users and non-users of PHIMed, to study perceptions around its role, key features, barriers and facilitators, and any unintended consequences. WP2 will involve documentary analysis of how PHIMed is used, what is documented and read, and by whom, in a stratified sample of 60 PHIMed users. In WP3, we will carry out a descriptive analysis of PHIMed tools used/available, both electronic and paper, and categorise their design and key features based on those identified in WP1/2. Finally, in WP4, findings from WPs 1–3 will be integrated and analysed using distributed cognition as a theoretical framework to explore how information is recorded, transformed and propagated among different people and artefacts.

Ethics and dissemination The study has National Health Service ethics approval. It will provide initial recommendations around the present use of PHIMed to optimise patient care for patients, carers and healthcare professionals.

  • patient held records
  • medication
  • patient activation
  • qualitative research

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  • Contributors SG and BDF led on study design and protocol writing with assistance from the other authors. DF wrote the sections relating to the use of DiCoT. FH and MT were actively involved in discussions leading to this proposal and have had substantial input into the scope of the proposal.

  • Funding This work was supported by Pharmacy Research UK grant number PRUK-2016-PG2-2-A and by the National Institute for Health Research (NIHR) Imperial Patient Safety Translational Research Centre. This report presents independent research funded by Pharmacy Research UK (PRUK).

  • Disclaimer The views expressed in this publication are those of the authors not necessarily those of PRUK, the NHS, the NIHR or the Department of Health.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval This proposal has been approved by East Midlands—Nottingham 2 Research Ethics Committee ref (17/EM/0477).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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