title: Exploring the effects of patients taking a vigilant role in collaborating on their e-medication administration record.
abstract: OBJECTIVE
  Errors in the electronic medication administration record (eMAR) occur in 25.6% of cases, mainly due to communication errors. The aim of this study is to investigate whether the quality of the eMAR improves when patients play a vigilant role by checking their medication using a patient communication tool linked to their eMAR (eMAR-PCT) to communicate asynchronously with the pharmacist about errors. Effects on health outcomes and self-care are also explored.
  
  
  METHODS
  In this quasi-experimental study, polypharmacy patients using five or more medications were randomly selected and invited to use their eMAR-PCTs. Participants also received two digital questionnaires assessing health and self-care (week 0 and 26). Statistical analyses were performed on two subgroups: eMAR-PCT users and non-users.
  
  
  RESULTS
  An inclusion rate of 43.5% (n=152) was achieved. Women were more prevalent than men among the users group (56.4% vs. 43.6%). Among the eMAR-PCT users, 75% logged in more than once, and 17.9% communicated asynchronously with the pharmacist. The content of the e-mails shows that eMAR-PCT was used as intended. No improvement in the quality of the eMAR was found. The self-care variables self-efficacy (p=.006) and collaboration with the pharmacist (p=.021) showed significant improvement in the users group.
  
  
  CONCLUSIONS
  The results showed no effect on eMAR quality and a modest improvement in self-care. Active digital patient participation to improve the quality of eMAR merits further investigation as, in line with other research, tentatively positive results are shown on self-care. Possibilities for implementation are promising as half of the patients who pledged to use eMAR-PCT actually did, and used it as intended.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands; Stichting Transmurale Zorg Den Haag EO, The Hague, Netherlands. Electronic address: c.c.dejong-8@umcutrecht.nl.
authors.forename: Catharina C
authors.initials: CC
authors.lastname: de Jong
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Wynand J G
authors.initials: WJ
authors.lastname: Ros
authors.affiliation: Stichting Transmurale Zorg Den Haag EO, The Hague, Netherlands.
authors.forename: Mia
authors.initials: M
authors.lastname: van Leeuwen
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Guus
authors.initials: G
authors.lastname: Schrijvers
mesh_terms: D022126:Access to Information; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003299:Cooperative Behavior; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D050316:Medical Order Entry Systems / Q000706:statistics & numerical data*; D008508:Medication Errors / Q000517:prevention & control*; D008510:Medication Systems, Hospital / Q000706:statistics & numerical data*; D008875:Middle Aged; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D012648:Self Care; D055815:Young Adult
chemical_list: D004364:Pharmaceutical Preparations
keywords: Medication adherence; Medication errors; Patient participation; Self-care; Telemedicine; eHealth