Background and importance Studies suggest that in the hospital setting, prescribing errors are most common at admission, largely due to challenges of medication reconciliation. Problems are also common following transfer from hospital into the community and when attending outpatient appointments. Many patients who take medications use patient held information about medication (PHIMed) to improve transfer of medication related information across care settings. However, it is not known how PHIMed is used in practice and the extent to which PHIMed tools available meet the needs of patients and healthcare professionals. Discussion with patients and carers highlighted this as a priority for research.

Aim and objectives To identify how PHIMed is used in practice, barriers and facilitators to its use, and its role in supporting medication safety.

Material and methods We used a mixed methods design comprising two focus groups with patients and carers, 16 semi-structured interviews with healthcare professionals, 60 semi-structured interviews with PHIMed users, a quantitative features analysis of PHIMed solutions available in the UK and usability testing of four PHIMed tools. Participants were identified and recruited in Greater London in 2018, using advertisements on social media, our professional networks and face to face recruitment in outpatient clinics. Findings were triangulated using thematic analysis using distributed cognition for teamwork (DiCoT) models as sensitising concepts. NHS ethics approval was obtained.

Results We found that PHIMed was viewed positively by patients and carers using it and healthcare professionals. We identified a wide range of mechanisms through PHIMed improved medication safety, such as identification of potential drug interactions. However, a key barrier to use was lack of awareness by patients and carers that healthcare information systems are often fragmented, which meant that they had not identified a need for PHIMed. Different PHIMed tools met different needs, with no ‘one size fits all’ solution. No tools currently meet the core needs of all users.

Conclusion and relevance Healthcare professionals should raise awareness among patients and carers of the potential safety benefits of carrying and using PHIMed, encourage its use during consultations and be able to signpost to some of the tools and features available. PHIMed tool developers should modify their tools in order to meet all core user requirements.

References and/or acknowledgements No conflict of interest.