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Involvement in medication safety behaviors among older people with chronic diseases: systematic review of intervention studies

BMC Geriatrics volume 24, Article number: 841 (2024) Cite this article

Abstract

Background

This study aimed to systematically evaluate interventions and effects that promote involvement in medication safety among older people with chronic diseases and to provide new ideas and references for developing standardized and effective intervention strategies to improve patient involvement in medication safety.

Methods

A comprehensive literature search across twelve databases was conducted using both computerized and manual methods. The search was limited to studies designated as randomized controlled trials or quasi-experimental studies and was conducted from the time of each database’s inception until September 2023. Two researchers independently carried out qualitative analyses, which included screening the literature, extracting the data, and assessing the quality of the selected studies.

Results

This study included five studies involving a total of 388 participants, with interventions aimed at enhancing patient involvement in medication safety, including interactive health education, motivational interviewing, and medication reconciliation. However, direct evidence confirming the positive impact of these interventions in promoting medication safety behaviors among older people with chronic diseases is still lacking.

Conclusions

Patient involvement in medication safety behaviors is essential for promoting healthy aging. Medication education, motivational interviewing, and medication reconciliation may improve the willingness and ability of older people to participate. However, limitations in the methodological quality of current studies prevent drawing definitive conclusions, highlighting the urgent need for more high-quality research.

Trial registration

PROSPERO number CRD42023494924.

Peer Review reports

Background

According to the 2022 United Nations World Population Prospects report [1], the global population aged 60 and above in 2021 was 1.083 billion, with China accounting for approximately 23.8%, equivalent to approximately 258 million people. The aging population has led to a significant increase in the burden of chronic diseases. Statistics indicate that the prevalence of multiple chronic diseases among Swiss individuals aged over 65 years exceeds 60%, with more than 50% of patients experiencing three or more chronic diseases [2]. Pharmacological therapy is the primary method for managing chronic diseases. Older people with chronic diseases in places such as Europe and Lebanon typically require concurrent use of five or more medications, with the percentage ranging from 45.2% to 71.8% [3, 4], with an average daily frequency of four administrations [5]. This regimen includes high-risk medications necessitating monitoring and dosage adjustment, such as hypoglycemic, antihypertensive, and cardiovascular agents. Nevertheless, China’s older people frequently demonstrate unsafe medication practices, including adjusting medication types, dosages, and frequencies (63.63%), self-discontinuation of medication based on symptom improvement or worsening (53.8%), forgetfulness in medication adherence (48.7%), irregularity or omission of doses (44.1%), failure to adhere to medication monitoring schedules (43.75%), and errors in timing or substitution of medications (18.81%) [6,7,8]. These unsafe medication behaviors can predispose older people to safety incidents, including falls, cognitive decline [9], while also diminishing the efficacy and safety of medications and escalating the national financial burden (global costs attributed to medication errors are estimated at 42 billion US dollars annually) [10,11,12].

Each individual bears primary responsibility for their health. The “Global Patient Safety Action Plan 2021–2030” [13] and the “Healthy China Action (2019–2030)” [14] advocate that the public enhance their proactive health consciousness and actively engage in self-care and health practices. In 2022, the patient safety advocate Helen Haskell introduced “Patient Involvement in Medication Safety” during a series of drug safety network seminars held by the WHO, emphasizing the core role of patients in ensuring medication safety [15]. “Patient involvement in medication safety” is a strategy for reducing medication injury and errors and is characterized by being “patient-centered” [16] and “personalized” [17], with studies primarily focusing on countries such as the United Kingdom [18,19,20], the United States [21,22,23], and Australia [24,25,26]. Currently, there is no unified definition of the term “patient involvement in medication safety”. Wang Binghan [27] described that patient involvement in medication safety refers to actions taken by patients with independent decision-making abilities to promote the safe, rational, and effective use of medication before, during, and after receiving standard medical treatments. “Patient involvement in medication safety” has been proven to fully mobilize the enthusiasm and initiative of patients and effectively reduce medication errors [13]. For instance, Zhang Huiling [28] implemented a phased and progressive patient involvement in medication safety management plan for older people with cardiovascular conditions at home, tailored to their varying medication needs at different stages. This approach effectively raised patients’ awareness of and engagement in medication safety management, encouraging them to take an active role in ensuring their own medication safety. However, research on safeguarding patient medication safety from the perspective of “patient involvement” is still in its infancy. Although there has been some practice in medication education for older people with coronary heart disease and diabetes, there is still insufficient direct evidence to prove the effectiveness of “Patient involvement in medication safety.” Existing studies have yet to clarify the specific impact and implementation methods of such interventions, and significant uncertainty remains about how to effectively encourage older people to actively engage in medication safety.

This study aimd to systematically evaluate interventions to improve participation in medication safety behaviors among older people with chronic diseases, providing new ideas and references for the development of subsequent intervention plans and research.

Research design and methods

The study was conducted from June 2023 to January 2024 and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. To complement and extend the PRISMA protocol, we used the Synthesis Without Meta-analysis in the Systematic Reviews Checklist recommended by the EQUATOR network (“Enhancing the Quality and Transparency of Health Research”; www.equator-network.org) [29]. Registered as PROSPERO CRD42023494924. The systematic review was performed based on the following stages: (a) defining suitable keywords, (b) finding and selecting studies and articles in different databases, (c) critical evaluation of these studies, (d) data selection and analysis, and (e) presentation and interpretation of the results.

Search strategy

A comprehensive search, both computerized and manual, was conducted across 12 electronic databases, encompassing PubMed, Web of Science, CENTRAL, CINAHL, Medline, EMBASE, Ovid, PsycINFO, CNKI, WanFang Data, CBM, and VIP. This search extended from the inception of each database to September 2023. A combination of subject terms and free terms was used and adapted to the characteristics of each database. Additionally, the references of the included studies were also searched, and relevant information was obtained through snowballing. The search terms used were “aged/elderly/older people, patient participation/patient engagement/patient involvement/patient empowerment/patient activation/shared decision-making/person-centered care/person centered/patient focused, medication management/medication self-management/safety medication, intervention/application/impact/effectiveness and randomized controlled trial/controlled clinical trial/random*/placebo*/trial/groups”. The full search strategy, using PubMed as an example, is provided in Additional file 1: Appendix 1.

Eligibility criteria

The inclusion criteria for the study were delineated using the PICOS format, as detailed below: P (population): older people with chronic diseases (aged 60 years or older) [30]; I (intervention): patient involvement or patient involvement in medication safety as the main intervention strategy, without restricting the others for the time being; C (control): including a blank control, routine control, among others; O (outcome): patient involvement in medication safety behaviors and positivity; and S (study design): requiring the inclusion of randomized controlled trials or quasi-experimental studies. The Exclusion criteria were non-Chinese and non-English literature, reviews, case reports, qualitative research, conference papers, and those with incomplete data, inaccessible full texts, or redundant publications. Any study that met one or more of the above criteria was excluded. The intervention criteria examples can be found in Additional file 2: Appendix 2.

Study selection and data extraction

Two researchers independently conducted literature screening and data extraction, with a third researcher assisting in judgment in case of disagreement. The initial search results were deduplicated using EndNote 20 software. Subsequently, titles and abstracts of the literature were reviewed to exclude clearly irrelevant studies, followed by a thorough evaluation of the full texts to assess their eligibility against the inclusion criteria. Additionally, the references of the included studies were supplemented using the snowballing method. Where necessary, the authors of the original studies were contacted by email and telephone to acquire information that was not identified but was important for this study.The following data were extracted using standardized tables: first author and year of publication; country; study design; study population; total sample size and dropout rate; elements of the intervention (intervention measures, intervention frequency, intervention period, intervention duration, etc.); study setting; time of evaluation; outcome indicators and research tools; and study results.

Risk of bias in individual studies

The quality assessment of the included randomized controlled trials (RCTs) was performed according to the protocol established in the Cochrane Handbook 5.1.0 [31]. This approach included random allocation, allocation concealment, blinding of implementers and participants, blinding of outcome assessors, complete reporting of data, selective reporting of results, and other sources of bias, such as sample size estimation and baseline comparability, and offered three ratings for each item: “low risk of bias,” “high risk of bias,” or “unclear.” Original studies were assigned a quality rating of A if all the above criteria were fully met, B if the criteria were partially met, and C if they failed to meet the criteria entirely.

For the quality assessment of quasi-experimental studies, the MINORS scale [32], which comprises 12 items, was used. Each item was scored from 0 to 2, with 0 indicating nonreporting, 1 indicating reporting insufficient information, and 2 indicating reporting and providing sufficient information.

The literature evaluation process was independently conducted by two researchers, and any disagreements were resolved through discussion. A third researcher was consulted if an agreement could not be reached.

Data synthesis

A narrative synthesis method was used due to the considerable variation between the study designs of the included studies.

Results

Study search and selection

In this study, a comprehensive systematic search across 12 domestic and international electronic databases yielded a total of 1,385 records: PubMed (n = 148), Web of Science (n = 196), CENTRAL (n = 716), CINAHL (n = 36), MEDLINE (n = 67), Ovid (n = 124), Embase (n = 29), PsyINFO (n = 10), CNKI (n = 32), Wangfang Data (n = 9), VIP (n = 12), and CBM (n = 6). After removing duplicates (n = 152) using EndNote 20 software, the titles and abstracts of the literature were read for screening (n = 1233), and 1189 records were excluded from the list of records that were completely irrelevant to the study topic (n = 1087), nonpatient involvement in medication safety interventions (n = 21), qualitative research (n = 28), reviews (n = 14), repeated publications (n = 2), and other nonconformities (n = 37). A full-text search of potentially relevant literature was conducted (n = 44), and the literature was selected against the inclusion criteria, resulting in a review of five intervention studies, where other sources (n = 3) were derived from the reference lists of the included studies. The literature review screening process is summarized in Fig. 1.

Fig. 1
figure 1

Flow diagram of the literature screening process

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Quality assessment

The evaluation of the literature quality is presented in Tables 1 and 2. The quality of evidence from the four included articles received a rating of B, and one was rated as C, signifying that the included studies carried a moderate to high risk of bias.

Table 1 Quality assessment of the included RCTs
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Table 2 Quality assessment of the included quasi-experimental studies
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Studies and participants

Basic data extraction details are provided in Table 3. We included five studies [28, 33,34,35,36], comprising one study from America and four from China, published between 2010 and 2022, with a total of 388 participants. Of these, two were randomized controlled trials, whereas the remaining three were quasi-experimental studies. The types of chronic diseases studied included coronary heart disease [28, 36], diabetes mellitus [35], and mixed types of chronic diseases [28, 33,34,35,36]. The sample size ranged from 70 to 120, with dropout rates varying between 5.32% and 18.98% across the studies [28, 33,34,35,36]. In terms of intervention elements, the main patient engagement interventions to ensure medication safety included health education [28, 33,34,35,36], motivational interviewing [28], medication reconciliation [34]. Intervention formats include one-on-one interventions [28, 33,34,35,36], group interventions [33, 35], offline interventions [28], combined online and offline interventions [33, 35], and online interventions [36]. Patient engagement hardware and software platforms/tools included a WeChat platform [35, 36], an intelligent medication management system [36], the ‘5 Moments of Medication Safety’ tool [35], a medication dispenser box [35], a reminder box [28], and a home involvement medication safety guidebook [28]. The durations for intervention/follow-up were predominantly 12 weeks [28, 34,35,36], although one study did not specify this information [33]. The intervention periods were hospital-home transition [34,35,36] and within-home/community settings [28, 33]. In terms of intervention frequency, hospitalization periods were 1–2 times per day [35], home periods were 1–2 weekly interventions [28] or 1 time per month [34, 35], one study supervised throughout [36], and one study was unknown [33]. The intervention duration was 10–15 min for telephone counseling [33], 20 min for online health education [35], 30–40 min for offline health education [35], 30–60 min for motivational interviews [28], 2 h for seminars [33], and unknown in one study [34]. Assessments were systematically conducted at defined time points, including at baseline [28, 33,34,35,36], at discharge [35], on day 7 postdischarge [34], at the end of the 1st month postdischarge [34], at the end of the 2nd month postdischarge [34], at the end of the intervention [28, 33,34,35,36], at the 4th postintervention weekend [28, 35], at the end of the 3rd month postintervention [28], and at the end of the 6th month postbaseline [33]. The outcome indicators included psychosocial (i.e., patient involvement in medication safety [34,35,36]/ positivity [28, 33]/ self-efficacy [28, 33,34,35,36]/ medication bias [28, 34, 35]/ health literacy [35, 36], etc.), disease-specific (i.e., blood glucose [34]/blood lipids [35]/angina severity [35], etc.), and health care utilization (i.e., readmission rates [35]) variables.

Table 3 Basic information of included literature
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Discussion

This study systematically reviewed the effectiveness of interventions aimed at promoting older people’s involvement in medication safety behaviors. The five studies included [28, 33,34,35,36] demonstrated that interventions such as health education, motivational interviewing, and medication reconciliation effectively enhanced older people’s health literacy, medication engagement, and self-efficacy.

The findings revealed the diversity and complexity of interventions focused on “Patient involvement in medication safety.” The effectiveness of interventions varied significantly across different settings. In hospitals, interventions were mainly delivered through face-to-face, individual or group formats [35, 36], focusing on medication decision-making and reconciliation [35]. This process involved comparing the patient’s current medications with prescribed regimens to ensure consistency, adjusting inappropriate medications in collaboration with the healthcare team, and improving older people’s sense of safety and involvement in medication management [37, 38]. This aligns with the findings of Beuscart JB [37].

In community or home settings, interventions were more focused on regular health education [28, 33] and motivational interviewing [28], equipping older people with skills in medication storage, handling expired drugs, and self-monitoring. These measures helped them adjust their medication lists and manage potential side effects [39, 40]. Health education not only increased patients’ awareness of medication use but also encouraged their active involvement in medication safety behaviors, thus reducing medication errors [36, 41]. In this study, effective medication education formats included one-on-one interactive knowledge sessions [36], peer education [36], online lectures and Q&A [36], and telephone follow-ups [34,35,36]. Other studies have shown that feedback-based education can improve patient safety and foster shared decision-making [42, 43]. Motivational interviewing emphasized patient self-decision-making, strengthening doctor-patient cooperation and communication, thereby encouraging greater involvement in medication safety [28, 44].

During the transition from hospital to home, intervention formats became more diverse, with increasing use of hybrid online and offline approaches [35, 36] and even fully online methods [35]. Examples include the use of WeChat platforms [36] and intelligent medication management systems [34], which expanded the channels for patient involvement in medication safety and facilitated better information sharing between patients and healthcare providers. Current technologies also include mobile apps [45], smart pillboxes [46], and Bluetooth wearable devices [47]. However, older people may resist or face barriers to adopting mobile health technologies due to low electronic health literacy, personal habits, or complex device interfaces [48], and the actual effectiveness of these interventions remains to be further validated. Moreover, differences in the tools used to assess patient involvement across studies could affect the comparability of results, highlighting the need for standardized tools to ensure consistency in research findings [49].

Patient involvement in medication safety is an active process of acquiring disease and medication information, empowering individuals to identify medication-related issues [50]. As involvement increases, positive changes occur in medication management behaviors [51], helping older people develop self-management and self-care abilities [52]. Sediling [53] demonstrated that hospitalized patients’ involvement in medication safety management effectively prevented medication errors, improved adherence, and enhanced treatment outcomes. The studies by Niu Xiaodan [35] and Li Na [36] further emphasized the critical role of patient involvement in improving lipid profiles and managing blood glucose. However, most older people with chronic conditions have not fully recognized their role in health management [28]. Current clinical practice often prioritizes disease-specific treatment, neglecting a comprehensive assessment of the patient’s overall health status [54], which increases medication risks for older people with multiple chronic conditions [55]. Therefore, it is crucial to position patients as the central subjects in health management, encouraging their active involvement in medication safety management. The theme of World Patient Safety Day 2022, “Medication Safety: Medication Without Harm,” also underscored the global trend of empowering patients to take an active role in the medication process [56].

Despite the positive effects shown by these interventions, there remains a lack of detailed data regarding intervention frequency, duration, and the relative importance of different components. The included studies were of low quality, with considerable heterogeneity in intervention forms and content, and small sample sizes, limiting the generalizability and comparability of results. Therefore, more high-quality research is needed to verify the impact of these interventions on older people’s involvement in medication safety behaviors. Future studies should also strive to standardize the evaluation tools for patient involvement and develop more tailored interventions based on the individualized needs of older people to ensure their effective participation in medication safety management.

Conclusion

It is crucial for older people to engage in medication safety behaviors. Analysis of the studies revealed that interventions for patient engagement in medication safety involved techniques such as interactive health education, motivational interviewing, and medication reconciliation. Unfortunately, there are few programs and participants that empower older people to engage in medication safety. There is a lack of direct evidence showing that these interventions can effectively improve medication safety behaviors in older people with chronic conditions. Therefore, more high-quality studies are needed to assess the true effects of these interventions and offer better support and guidance to older patients. Therefore, comprehensive studies on the motivational mechanisms and barriers to participation in medication safety among older people with chronic diseases are essential to effectively promote proper engagement in medication safety behaviors among older people, thereby enhancing patient health and safety.

Data availability

Data supporting the results of this study are provided in the Supplementary Information document.

Abbreviations

CENTRAL:

Cochrane Central Register of Controlled Trials

CINAHL:

Cumulative Index to Nursing and Allied Health Literature

MEDLINE:

Medical Literature

PsycINFO:

Psychology Informatics

CNKI:

China National Knowledge Infrastructure

WanFang Data:

China WanFang Data

VIP:

China Science and Technology Journal Database

CBM:

China Biology Medicine disc

OVID:

Ovid Technologies

EMBASE:

Excerpta Medica Database

PRISMA:

Preferred Reporting Items for Systematic Review and Meta-Analysis

PROSPERO:

Prospective Register of Systematic Reviews

EQUATOR:

Enhancing the quality and transparency of health research

RCT:

Randomized Controlled Trial

MINORS:

Methodological Index for Nonrandomized Studies

References

  1. United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects 2022. 2022. https://population.un.org/wpp/. Accessed 1 December 2023.

  2. Bähler C, Huber CA, Brüngger B, Reich O. Multimorbidity, health care utilization and costs in an elderly community-dwelling population: a claims data based observational study. BMC Health Serv Res. 2015;15:23.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Hanna V, Chahine B, Souheil FA. Attitudes of Lebanese community-dwelling older adults towards deprescribing using the rPATD tool. Arch Gerontol Geriatr. 2023;105:104840.

    Article  PubMed  Google Scholar 

  4. Ye L, Yang-Huang J, Franse CB, Rukavina T, Vasiljev V, Mattace-Raso F, et al. Factors associated with polypharmacy and the high risk of medication-related problems among older community-dwelling adults in European countries: a longitudinal study. BMC Geriatr. 2022;22(1):841.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Sluggett JK, Chen EYH, Ilomäki J, Corlis M, Van Emden J, Hogan M, et al. Reducing the burden of complex medication regimens: simplification of medications prescribed to long-term care residents (SIMPLER) cluster randomized controlled trial. J Am Med Dir Assoc. 2020;21(8):1114-1120.e4.

    Article  PubMed  Google Scholar 

  6. Zhao LB, Huang HH, Xiao F, Wu CF, Wang RQ, Zhao QH. Medication discrepancies in older patients with polypharmacy during the hospital-to-home transitional period. J Nurs Sci. 2023;38(6):121–6.

    Google Scholar 

  7. Chen W, Fang Q, Li ZZ. Investigation and countermeasures on the status quo of home medication for older people with chronic diseases. Drug Evaluation. 2023;20(6):758–61.

    Google Scholar 

  8. Wu XL. Exploring the need for rational medication management in the elderly community. China Health Industry. 2018;15(13):38–9.

    Google Scholar 

  9. Wong C. Medication-related problems in older people: how to optimise medication management. Hong Kong Med J. 2020;26(6):510–9.

    CAS  PubMed  Google Scholar 

  10. United Nations. "Harmless medicine": no one should be harmed in medical treatment. 2022. https://news.un.org/zh/story/2022/09/1109551. Accessed 1 December 2023.

  11. Wan M, Yuan W, Pan CL, Zhu JM, Ma HH, Shi DL, et al. Status quo and influencing factors of medication deviation during the hospital-family transition of patients after PCI. Chinese Gen Pract Nurs. 2023;21(4):537–41.

    Google Scholar 

  12. Markle-Reid M, McAiney C, Ganann R, Fisher K, Gafni A, Gauthier AP, et al. Study protocol for a hospital-to-home transitional care intervention for older adults with multiple chronic conditions and depressive symptoms: a pragmatic effectiveness-implementation trial. BMC Geriatr. 2020;20(1):240.

    Article  PubMed  PubMed Central  Google Scholar 

  13. World Health Organization. Global Patient Safety Action Plan 2021–2030. 2021. https://www.who.int/publications-detail-redirect/9789240032705. Accessed 1 December 2023.

  14. The State Council of the People's Republic of China. Healthy China Initiative (2019–2030). 2019. http://www.gov.cn/xinwen/2019-07/15/ content_5409694.htm. Accessed 1 December 2023.

  15. Pharmacognosy of Tencent. World Patient Safety Day 2022: Medication Safety.. 2022. https://new.qq.com/rain/a/20220221A01C8X00. Accessed 1 December 2023.

  16. Kitson A, Marshall A, Bassett K, Zeitz K. What are the core elements of patient-centred care? A narrative review and synthesis of the literature from health policy, medicine and nursing. J Adv Nurs. 2013;69(1):4–15.

    Article  PubMed  Google Scholar 

  17. Tobiano G, Jerofke-Owen T, Marshall AP. Promoting patient engagement: a scoping review of actions that align with the interactive care model. Scand J Caring Sci. 2021;35(3):722–41.

    Article  PubMed  Google Scholar 

  18. Davis RE, Vincent C, Sevdalis N. Predictors of patients’ intentions to participate in incident reporting and medication safety. J Patient Saf. 2015;11(4):191–7.

    Article  PubMed  Google Scholar 

  19. Mohsin-Shaikh S, Garfield S, Franklin BD. Patient involvement in medication safety in hospital: an exploratory study. Int J Clin Pharm. 2014;36(3):657–66.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Fylan B, Armitage G, Naylor D, Blenkinsopp A. A qualitative study of patient involvement in medicines management after hospital discharge: an under-recognised source of systems resilience. BMJ Qual Saf. 2018;27(7):539–46.

    Article  PubMed  Google Scholar 

  21. Prey JE, Polubriaginof F, Grossman LV, Masterson Creber R, Tsapepas D, Perotte R, et al. Engaging hospital patients in the medication reconciliation process using tablet computers. J Am Med Inform Assoc. 2018;25(11):1460–9.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Heyworth L, Paquin AM, Clark J, Kamenker V, Stewart M, Martin T, et al. Engaging patients in medication reconciliation via a patient portal following hospital discharge. J Am Med Inform Assoc. 2014;21(e1):e157–62.

    Article  PubMed  Google Scholar 

  23. Kim JM, Suarez-Cuervo C, Berger Z, Lee J, Gayleard J, Rosenberg C, et al. Evaluation of patient and family engagement strategies to improve medication safety. Patient. 2018;11(2):193–206.

    Article  PubMed  Google Scholar 

  24. Bucknall T, Fossum M, Hutchinson AM, Botti M, Considine J, Dunning T, et al. Nurses’ decision-making, practices and perceptions of patient involvement in medication administration in an acute hospital setting. J Adv Nurs. 2019;75(6):1316–27.

    Article  PubMed  Google Scholar 

  25. Tobiano G, Manias E, Thalib L, Dornan G, Teasdale T, Wellwood J, et al. Older patient participation in discharge medication communication: an observational study. BMJ Open. 2023;13(3):e064750.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Manias E, Bucknall T, Hughes C, Jorm C, Woodward-Kron R. Family involvement in managing medications of older patients across transitions of care: a systematic review. BMC Geriatr. 2019;19(1):95.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Wang BH, Yan QY, Zhu Q. The development and psychometric assessment of inpatients involvement in patient medication safety scale. Chin J Nurs. 2017;52(03):377–80.

    Google Scholar 

  28. Zhang HL. Design and application of patient participation in medication safety management plan for older people with cardiovascular disease at home. Master: Zhengzhou University. Zhengzhou China; 2017.

    Google Scholar 

  29. Campbell M, McKenzie JE, Sowden A, Katikireddi SV, Brennan SE, Ellis S, et al. Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline. BMJ. 2020;368: l6890.

    Article  PubMed  PubMed Central  Google Scholar 

  30. The Central People's Government of the People's Republic of China. The Law on the Protection of the Rights and Interests of Older People of the People's Republic of China. 1996.https://www.gov.cn/banshi/2005-05/25/content_952.htm. Accessed 19 September 2024.

  31. Better health of Trusted evidence Informed decisions of Cochrane Training. Cochrane Handbook for Systematic Reviews of Interventions Chinese Translation Edition. 2011.https://training.cochrane.org/zhhans/cochrane-%E5%B9%B2%E9%A2%84%E6%8E%AA%E6%96%BD%E7%B3%BB%E7%BB%9F%E8%AF%84%E4%BB%B7%E6%89%8B%E5%86%8C%E4%B8%AD%E6%96%87%E7%BF%BB%E8%AF%91%E7%89%88.Accessed 1 December 2023.

  32. Zeng XT, Zhuang LP, Yang ZG, Dong SJ. Meta-analysis Series No. 7: Non-randomized Experimental Studies, Diagnostic Tests and Quality Assessment Tools for Animal Experiments. Chin J Evid Based Cardiovasc Med. 2012;4(6):496–9.

    Google Scholar 

  33. Hochhalter AK, Song J, Rush J, Sklar L, Stevens A. Making the Most of Your Healthcare intervention for older adults with multiple chronic illnesses. Patient Educ Couns. 2010;81(2):207–13.

    Article  PubMed  Google Scholar 

  34. Mao JY. Optimization of intelligent medicationadministration system and efficacy in olderadults with chronic diseases during hospitalization and home period. Master: Chongqing Medical University, Chongqing China; 2022.

    Google Scholar 

  35. Niu XD. Application of medication reconciliation on medication discrepancy in hospital-family transitional period in older people with type 2 diabetes mellitus. Master: Lanzhou University, Lanzhou China; 2021.

    Google Scholar 

  36. Li N. The Influence of interactive medication literacy intervention on medication safety in patients with coronary heart disease. Master: University of South China, Hengyang China; 2021.

    Google Scholar 

  37. Beuscart JB, Pelayo S, Robert L, Thevelin S, Marien S, Dalleur O. Medication review and reconciliation in older adults. European Geriatric Medicine. 2021;12(3):499–507.

    Article  PubMed  Google Scholar 

  38. Szanton SL, Wolff JW, Leff B, et al. CAPABLE trial: A randomized controlled trial of nurse, occupational therapist and handyman to reduce disability among older adults: Rationale and design. Contemp Clin Trials. 2014;38(1):102–12.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Lough MA. Ongoing work of older adults at home after hospitalization. J Adv Nurs. 1996;23(4):804–9.

    Article  CAS  PubMed  Google Scholar 

  40. Eassey D, McLachlan AJ, Brien JA, Krass I, Smith L. I have nine specialists. They need to swap notes!” Australian patients’ perspectives of medication-related problems following discharge from hospital. Health Expect. 2017;20(5):1114–20.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Miller WR, Rollnick S. Motivational Interviewing: Helping People Change and Grow. 4th ed. New York: Guilford Press; 2023.

    Google Scholar 

  42. Ha Dinh TT, Bonner A, Clark R, et al. The effectiveness of the teach-back method on adherence and self-management in health education for people with chronic disease: a systematic review. JBI Database System Rev Implement Rep. 2016;14(1):210–47.

    Article  PubMed  Google Scholar 

  43. Oh EG, Lee JY, Lee HJ, et al. Effects of discharge education using teach-back methods in patients with heart failure: A randomized controlled trial. Int J Nurs Stud. 2023;140:104453.

    Article  PubMed  Google Scholar 

  44. Pérula de Torres LA, Ortega LP, de Torres CP, Lama JG, Caro IO, Moral RR, et al. Efficacy of motivational interviewing for reducing medication errors in chronic patients over 65 years with polypharmacy: Results of a cluster randomized trial. Medicina Clinica. 2014;143(8):341–8.

    Google Scholar 

  45. Searcy RP, Summapund J, Estrin D, et al. Mobile Health Technologies for Older Adults with Cardiovascular Disease: Current Evidence and Future Directions. Current Geriatrics Reports. 2019;8(1):31–42.

    Article  Google Scholar 

  46. Tinylogics. Smart Pillbox. 2016. https://pillbox.tinylogics.com/collections/all-product. Accessed 19 September 2024.

  47. Gjeka R, Patel K, Reddy C, et al. Patient engagement with digital disease management and readmission rates: The case of congestive heart failure. Health Informatics J. 2021;27(3):14604582211030960.

    Article  PubMed  Google Scholar 

  48. Fan YM, Cao SM, Jia YY, et al. Meta integration of qualitative studies on mobile health adoption attitudes and influencing factors in the elderly. J Nurs Train. 2023;38(11):1017–22.

    Google Scholar 

  49. Bekker CL, Aslani P, Chen TF. The use of medication adherence guidelines in medication taking behaviour research. Res Social Adm Pharm. 2022;18(2):2325–30.

    Article  PubMed  Google Scholar 

  50. Tobiano G, Chaboyer W, Teasdale T, Cussen J, Raleigh R, Manias E. Older patient and family discharge medication communication: A mixed-methods study. J Eval Clin Pract. 2021;27(4):898–906.

    Article  PubMed  Google Scholar 

  51. Hibbard JH, Mahoney ER, Stock R, et al. Do increases in patient activation result in improved self-management behaviors? Health Serv Res. 2007;42(4):1443–63.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Kim JY, Wineinger NE, Steinhubl SR. the influence of wireless self-monitoring program on the relationship between patient activation and health behaviors, medication adherence, and blood pressure levels in hypertensive patients: a substudy of a randomized controlled trial. J Med Internet Res. 2016;18(6):e116.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Seidling HM, Woltersdorf R. Verbesserung der Arzneimittel therapiesicherheit mitund frden patienten. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2018;61(9):1082–7.

    Article  PubMed  Google Scholar 

  54. Panaszek B, Machaj Z, Bogacka E, Lindner K. Chronic disease in the elderly: a vital rationale for the revival of internal medicine. Pol Arch Med Wewn. 2009;119(4):248–54.

    Article  PubMed  Google Scholar 

  55. Li XY. Exploring management models for older people with co-morbidities. Chin J Geriatr Heart Brain Vessel Dis. 2022;24(5):449–52.

    CAS  Google Scholar 

  56. World Health Organization. World Patient Safety Day 2022. 2022. https://www.who.int/zh/news-room/events/detail/2022/09/17/default-calendar/world-patient-safety-day-2022. Accessed 1 December 2023.

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Acknowledgements

The authors would like to acknowledge Dan Wang, a teacher of medical literature retrieval, at Fujian Medical University, and Qing Chen, a clinical pharmacist, at the 900th Hospital of the People's Liberation Army Joint Command Security Force, for their contributions to the review.

Funding

This study was supported by the Natural Science Foundation of Fujian Province of China under grant number 2023J01700, and by The Key Projects on Civil Affairs Policy and Theory Research in Fujian Province(Grant NO.FMZD202402).

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Authors and Affiliations

  1. The School of Nursing, Fujian Medical University, Fuzhou, Fujian, China

    Weixi Xu, Xiaoyan Lin, Huiqi Lai, Yaqin Ren & Ting Lin

  2. Chinese People’s Liberation Army Joint Logistics Force 900, Hospital, Fuzhou, Fujian, China

    Hongjiang Ye

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  1. Weixi Xu
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Contributions

Ting Lin led the project and was responsible for the review and contributed substantially to the conception, design, drafting, and completion of the manuscript. Weixi Xu made a substantial contribution to the study conception and design, was involved in drafting the manuscript, literature searching, and screening, and contributed critically to important intellectual content. Xiaoyan Lin contributed to the design and acquisition of the data and the drafting of the manuscript. Huiqi Lai, Yaqin Ren and Hongjiang Ye contributed significantly to the design and acquisition of the data and participated in the drafting of the manuscript. Ting Lin, Weixi Xu, Huiqi Lai, Yaqin Ren and Hongjiang Ye provided final approval for the final version of the manuscript, take full responsibility for the content of the manuscript and agree to be accountable for all aspects of the work, including its accuracy and integrity. All authors have read and approved the final manuscript.

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Correspondence to Ting Lin.

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Xu, W., Lin, X., Lai, H. et al. Involvement in medication safety behaviors among older people with chronic diseases: systematic review of intervention studies. BMC Geriatr 24, 841 (2024). https://doi.org/10.1186/s12877-024-05449-5

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Keywords

BMC Geriatrics

ISSN: 1471-2318

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