Table 1

Potential mechanisms through which patient-held medication lists may enhance safety

Mechanism for addressing gap to enhance medication safetyExamples from dataSupporting field notes/quotations
Creating the ‘glue’ between disjointed healthcare systemsPatient-held medication lists filling the gap between different healthcare information technology systems that do not communicate.‘She first did it for the dentist but then found the hospital did not have her records so she used it there as well. The opticians also ask about her medicines so now she uses it there too. She has also used it in her GP’s surgery.’ (LU 58; field notes)
Enhancing situation awarenessPatient-held medication lists allowing prescribers to identify medicines that may interact with those they are about to prescribe.
Patient-held medication lists allowing more accurate and complete medicines reconciliation when patients are admitted to hospital.
Patient-held medication lists allowing adverse drug reactions to be identified.
‘Other standout moments have been when she has been prescribed something new and been able to say “hang on I am on this as well. Is it ok to be on them together?”’ (LU 52; field notes)
Checking for errorsPatients using medication lists to check that the medicines they are given at the pharmacy are correct.‘He has seen … the local pharmacist. He used the list for himself to check that what he was receiving was what was on the record.’ (LU 41; field notes)
Ease of communicationPatients using medication lists to communicate the medicines they are on more easily, especially when in pain, tired or when English is not their first language.‘We have a lot of patients that don’t speak English very well … and it’s very, very hard for them to communicate, … to convey what they’re taking and so they need support and for them to carry information like that.’ (Optician 2; quote)
Patient empowermentPatient-held medication lists allowing patients to feel in control of their health and their medication.‘He is the sort of person that likes to be well informed and make good decisions. He likes having his own local records as it gives a view of how you are.’ (LU 51; field notes)
Aide-mémoire during appointmentsMedication lists helping patients remember what they are on when talking to healthcare professionals.‘A standout moment when her medication list has been particularly helpful was when she was nervous about the appointment and so she knew she would forget. She had her phone in her hand ready as she knew they would ask.’ (LU 52; field notes)
Reminder to takeMedication lists reminding patients what to take when.
Patients can also use an alarm system with some apps.
‘Her medicines are arranged in times of administration so she can check off the list as she pops out her tablets. It is a reminder to her of what to take.’ (LU 50; field notes)
Reminder to reorderMedication lists helping patients to keep track of when they need to reorder medicines.‘She can never remember when she needs to get her prescription renewed. She uses her notepad app to remind her to put the date on her calendar. That way she knows when it was last issued, when she needs to order her repeats and when she needs blood tests.’ (LU 53; field notes)
  • GP, general practitioner; LU, medication list user.