Provider and public learning messages developed
| Healthcare provider message (release date) | Content addressing root causes; accessed at https://www.vchri.ca/richmond/pADE |
| Sick Day Medication Management (March 2018) | Hold SADMANS drugs while decreased fluid intake (to avoid hypotension, acute kidney injury or other side effect); hold sulfonylureas while decreased caloric intake (to avoid hypoglycaemia); hold warfarin for 1 day if eating 50% less and or severe diarrhoea. Dialogue is provided for how to confirm patient’s understanding, what they will do, when, why and how they will remember. S, sulfonylureas; A, ACE inhibitors; D, diuretics or direct renin inhibitor; M, metformin; A, angiotensin receptor blocker; N, non-steroidal anti-inflammatory drugs; S, SGLT2 inhibitors |
| Community and Nursing Home Acquired Pneumonia (May 2018) | Avoid macrolide monotherapy; use amoxicillin 1 g three times per day or alternate to target Streptococcus pneumoniae unless risk factors (provided) for other pathogens. |
| How to write an asthma action plan (April 2019) | Provides instructions to increase steroid dose ×4; confirm patient’s ability to identify yellow level symptoms; understanding of purpose of steroid inhaler for prevention of flare-up; assess inhaler technique; provide action plan. |
| How to identify and address intentional non-adherence (April 2019) | Provides suggested dialogue to explore patient’s current understanding/beliefs about medicines and condition, address gaps to help patient make an informed decision about the value of the medication, expected benefit. |
| Prevention of bleeding related pADEs (February 2019) | Describes how to ask screening questions to rule out NSAIDs in patients taking anticoagulants; how to confirm a patient can recognise red flag symptoms (side effects) and what they need to do; provides eligibility criteria for primary prevention. |
| Medication Mix Ups (May 2019) | Relates to situations where patients have resumed taking medications (existing supply at home) that were intended to be stopped; resumed old doses of medications, intended to be changed, did not fill prescription as unaware of a new medication. Provides suggested dialogue to confirm that patient and family can correctly identify what they need to do to successfully implement a medication change. |
| Public learning message | Content addressing root causes; accessed at https://vch.eduhealth.ca/ |
| Your Medication Plan for Sick days BA.505.S53 (March 2018) | Identifies which medications to not take while not drinking as much fluid, during an illness or not eating or severe diarrhoea and why this is important. |
| COPD Flare Up Plan FN.510.F66 (February 1019) | How to recognise symptoms of flare-up, what to do; why it is important to regularly use long-acting inhalers, how regular use of these would help them stay out of hospital and feel better and improve other symptoms of COPD not just breathing. |
| How to prevent worsening of heart failure symptoms. FD.780.H434 (March 2019) | Describes connection between fluid gain and weight gain and how this leads to symptoms; provides explanation for purpose and expected benefit of daily weighing; what to do if weight gain. |
| Measuring BP at home (and recognising orthostatic hypotension) BD.820.W74 (April 2019) | Explains purpose of taking antihypertensive medications; explains need to measure BP to know if medication is working. Describes specific symptoms of orthostatic hypotension and what to do. |
BP, blood pressure; COPD, chronic obstructive pulmonary disease; NSAIDs, non-steroidal anti-inflammatory drugs; pADEs, preventable adverse drug events.