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February 2020

Stopping medicines: Re-designing the process using Experience-based Co-design

By Dr Janice Olaniyan, Dr Iuri Marques, Dr Daisy Payne, Mr George Peat

In a previous blog entry, we shared our experience of conducting user (patient and supporting peers, who may support patients’ medicines use) and practitioner interviews, to understand the process of stopping medicines in primary care. After these interviews, we used Experience-based Co-design to determine how we can improve this service.

What is Experience-based Co-design?

Experience-based Co-design(EBCD)1 is a process in which patients and staff come together in different sessions to identify priorities to improve services. It is a unique Quality Improvement (QI) approach, which enables staff, patients and carers (or other service users) to jointly reflect on their experiences of a service and work together to identify and implement priorities for improvement.2 Before we began organising our EBCD sessions, we conducted qualitative interviews with patients, supporting peers and healthcare professionals to understand their views and experiences of having medicines stopped (for more information about this part of our research, please see our previous blog here).

Why did we use Experience-base Co-design?

We feel that involving those who have experienced stopping medicines that may no longer be appropriate for them is the best way to ensure we succeed in improving the process of stopping medicines. We can only fully understand and redesign services through real-life experiences of what works and what doesn’t work, and only service users and service providers can provide this insight. The EBCD approach differs from other service improvement techniques in that it is a partnership, with shared leadership between patients and professionals1, which focuses on patient and staff experiences and emotions through storytelling, to identify key opportunities for improvement.2

What exactly did we do?

Patients and their supporting peers were interviewed about their experiences of reducing or stopping their medicines. These interviews were video recorded, and the footage was captured and edited into a short film that summarised their experiences. We then held a number of workshops, which brought patients, their supporting peers, and clinicians (General Practitioners, Nurses, and Pharmacists) together in a neutral space that allowed for an open discussion about the process of reducing or stopping medicines. The short film, capturing patients’ and supporting peers’ views, was shown to the people that attended the workshops to help generate further discussions about experiences of reducing or stopping medication. After the workshops, an event was held to celebrate the contribution of everyone who was involved in the workshops.

What value did EBCD add to our research?

Conducting our EBCD sessions gave us the opportunity to take patients’, supporting peers’ and clinicians’ views into consideration to develop the ideal consultation process for stopping medicines in primary care. Participants came together to reflect on the real-life stories recorded during interviews, building on these to identify patient-centred priorities for improving the consultation and process of stopping medicines in primary care. Patients, their supporting peers and healthcare professionals told us that they enjoyed taking part and valued the opportunity to take an active role in improving the process of stopping medicines.

Where will we go from here?

We have heard what patients, supporting peers and healthcare professionals had to say and will use the information they gave us to redesign the process of stopping medicines in primary care before testing it.

More information

For more information about EBCD and our top five tips for involving Patients and members of the public in developing these sessions, please have a look at our newsletter article here.

References

 

  1. Donetto S, Tsianakas V, Robert G. Using Experience-based Co-design (EBCD) to improve the quality of healthcare: mapping where we are now and establishing future directions. London: King’s College; 2014.
  2. The Point of Care Foundation. EBCD: Experience-based co-design toolkit. Accessed from https://www.pointofcarefoundation.org.uk/resource/experience-based-co-design-ebcd-toolkit/step-by-step-guide/1-experience-based-co-design/. Date accessed 04/02/2020 at 17:00 pm