Background: Medication incidents (MIs) causing harm to patients have far-reaching consequences for patients, pharmacists, public health, business practice, and governance policy. Medication Incident Reporting and Learning Systems (MIRLS) have been implemented to mitigate such incidents and promote continuous quality improvement in community pharmacies in Canada. They aim to collect and analyze MIs for the implementation of incident preventive strategies to increase safety in community pharmacy practice. However, this goal remains inhibited owing to the persistent barriers that pharmacies face when using these systems.
Objective: This study aims to investigate the harms caused by medication incidents and technological barriers to reporting and identify opportunities to incorporate persuasive design strategies in MIRLS to motivate reporting.
Methods: We conducted 2 scoping reviews to provide insights on the relationship between medication errors and patient harm and the information system-based barriers militating against reporting. Seven databases were searched in each scoping review, including PubMed, Public Health Database, ProQuest, Scopus, ACM Library, Global Health, and Google Scholar. Next, we analyzed one of the most widely used MIRLS in Canada using the Persuasive System Design (PSD) taxonomy-a framework for analyzing, designing, and evaluating persuasive systems. This framework applies behavioral theories from social psychology in the design of technology-based systems to motivate behavior change. Independent assessors familiar with MIRLS reported the degree of persuasion built into the system using the 4 categories of PSD strategies: primary task, dialogue, social, and credibility support.
Results: Overall, 17 articles were included in the first scoping review, and 1 article was included in the second scoping review. In the first review, significant or serious harm was the most frequent harm (11/17, 65%), followed by death or fatal harm (7/17, 41%). In the second review, the authors found that iterative design could improve the usability of an MIRLS; however, data security and validation of reports remained an issue to be addressed. Regarding the MIRLS that we assessed, participants considered most of the primary task, dialogue, and credibility support strategies in the PSD taxonomy as important and useful; however, they were not comfortable with some of the social strategies such as cooperation. We found that the assessed system supported a number of persuasive strategies from the PSD taxonomy; however, we identified additional strategies such as tunneling, simulation, suggestion, praise, reward, reminder, authority, and verifiability that could further enhance the perceived persuasiveness and value of the system.
Conclusions: MIRLS, equipped with persuasive features, can become powerful motivational tools to promote safer medication practices in community pharmacies. They have the potential to highlight the value of MI reporting and increase the readiness of pharmacists to report incidents. The proposed persuasive design guidelines can help system developers and community pharmacy managers realize more effective MIRLS.
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http://dx.doi.org/10.2196/41557 | DOI Listing |
PLoS One
January 2025
Academic Unit for Ageing & Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom.
Background: Understanding recovery is important for patients with stroke and their families, including how much recovery is expected and how long it might take. These conversations can however be uncomfortable for stroke unit staff, particularly when they involve breaking bad news. This study aimed to begin development of a novel complex intervention to improve conversations about recovery on stroke units.
View Article and Find Full Text PDFActa Psychol (Amst)
January 2025
Fondazione Bruno Kessler, Via Sommarive, 18, 38123 Trento, Italy. Electronic address:
The increasing need to address climate change has intensified efforts to promote green transportation options, such as cycling and public transit. Over the past few decades, gamification-the integration of game-like elements into non-game contexts to motivate and engage people in adopting new behaviors-has emerged as a strategy to encourage the use of sustainable transportation. This literature review examines how gamification has been used to drive the adoption of green transportation.
View Article and Find Full Text PDFJMIR Pediatr Parent
January 2025
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland.
Background: Preteen girls of lower socioeconomic position are at increased risk of physical inactivity. Parental support, particularly from mothers, is positively correlated with girls' physical activity levels. Consequently, family-based interventions are recognized as a promising approach to improve young people's physical activity.
View Article and Find Full Text PDFHealth Commun
January 2025
Institute of Psychology, University of Bamberg.
According to psychological reactance theory, individuals who perceive a threat to or loss of valued behavior will experience reactance - an amalgam of anger and negative cognitions that motivates an effort to regain behavioral freedom. The limited effects of health communication interventions have often been attributed to psychological reactance, and previous research has tended to focus on how to design health messages that mitigate this phenomenon. However, the motivational nature of reactance suggests that it might also be used to promote health.
View Article and Find Full Text PDFBr J Gen Pract
December 2024
UCL, Research Department of Primary Care and Population Health, London, United Kingdom
Background: Chlamydia is the most diagnosed bacterial sexually transmitted infection in England, but opportunistic testing remains low in general practice despite high prevalence among young people. Attempts to increase testing have been met with little success; therefore, there is a need to explore why rates remain low and how this may be improved.
Aim: To explore general practice staff perceptions of opportunistic chlamydia testing, including barriers, facilitators, interventions, and policies, using the Behaviour Change Wheel (BCW).
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