title: Evaluating the effectiveness of self-administration of medication (SAM) schemes in the hospital setting: a systematic review of the literature.
abstract: BACKGROUND
  Self-administration of medicines is believed to increase patients' understanding about their medication and to promote their independence and autonomy in the hospital setting. The effect of inpatient self-administration of medication (SAM) schemes on patients, staff and institutions is currently unclear.
  
  
  OBJECTIVE
  To systematically review the literature relating to the effect of SAM schemes on the following outcomes: patient knowledge, patient compliance/medication errors, success in self-administration, patient satisfaction, staff satisfaction, staff workload, and costs.
  
  
  METHODS
  Keyword and text word searches of online databases were performed between January and March 2013. Included articles described and evaluated inpatient SAM schemes. Case studies and anecdotal studies were excluded.
  
  
  RESULTS
  43 papers were included for final analysis. Due to the heterogeneity of results and unclear findings it was not possible to perform a quantitative synthesis of results. Participation in SAM schemes often led to increased knowledge about drugs and drug regimens, but not side effects. However, the effect of SAM schemes on patient compliance/medication errors was inconclusive. Patients and staff were highly satisfied with their involvement in SAM schemes.
  
  
  CONCLUSIONS
  SAM schemes appear to provide some benefits (e.g. increased patient knowledge), but their effect on other outcomes (e.g. compliance) is unclear. Few studies of high methodological quality using validated outcome measures exist. Inconsistencies in both measuring and reporting outcomes across studies make it challenging to compare results and draw substantive conclusions about the effectiveness of SAM schemes.
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, B15 2WB, United Kingdom.
authors.forename: Suzanna J
authors.initials: SJ
authors.lastname: Richardson
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, B15 2WB, United Kingdom.
authors.forename: Hannah L
authors.initials: HL
authors.lastname: Brooks
authors.affiliation: Primary Care Clinical Sciences, School of Health & Population Sciences, University of Birmingham, Birmingham, B15 2TT, United Kingdom.
authors.forename: George
authors.initials: G
authors.lastname: Bramley
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, B15 2WB, United Kingdom; School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom.
authors.forename: Jamie J
authors.initials: JJ
authors.lastname: Coleman
mesh_terms: D007722:Health Knowledge, Attitudes, Practice; D006761:Hospitals; D006801:Humans; D017060:Patient Satisfaction; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D012646:Self Administration; D016896:Treatment Outcome; D016526:Workload
chemical_list: D004364:Pharmaceutical Preparations