Abstract: Abstract Background Medication safety management during the hospital-to-home transition for older adults with chronic disease is a key focus in public health. This study aims to develop and evaluate the feasibility and preliminary efficacy of a personalized Patient for Medication Safety (PFMS) intervention programme for older adults with chronic disease during this transition. Methods A parallel, two-arm, randomized controlled trial was conducted. The PFMS intervention included medication reconciliation before discharge, two bedside education sessions, a portable pillbox, and six remote motivational interviews over six weeks following discharge. Both the intervention and the control groups received usual care. Feasibility was assessed using recruitment rates, retention rates, intervention adherence, data collection completion rates, satisfaction surveys, and post-intervention interviews. Outcome measures (patient participation in medication safety, health literacy, healthcare worker support, and self-efficacy) were evaluated at baseline and post-intervention. The incidence and frequency of medication discrepancies were evaluated at one and six week post-discharge. Generalized estimating equations were used to examine within-group, between-group, and time-related changes in outcomes. Thematic analysis was used to analyse the qualitative data. Results A total of 30 patients were enrolled in the feasibility study, with 27 completing the study. The recruitment rate was 83.3%, retention rate 90%, and intervention adherence rate 81.3%. No adverse events occurred during the intervention period. Most participants reported high satisfaction. At the end of the intervention, significant differences were observed between the two groups in patient participation in medication safety (time effect), health literacy (between-group effect), medication discrepancies (time and interaction effects), and perceived healthcare provider support (between-group, time, and interaction effects) (all P 0.05). Patient feedback identified: (1) facilitators for accepting the PFMS intervention: care from healthcare workers and could benefit; (2) barriers: lack of comprehension and knowledge, lack of time, concern about bothering healthcare workers, negative attitudes associated with aging, sense of self-fulfillment, and intervention fatigue; (3) suggestions for improving the PFMS programme: increased identity credibility and provision of personalized support. Conclusions The PFMS intervention is feasible and shows preliminary efficacy in certain aspects during the hospital-to-home transition for older adults with chronic disease. Future research should refine the intervention to better enhance patient participation in medication safety behaviours and self-efficacy. Trial registration This trial was retrospectively registered on 18 April 2024 in the China Clinical Trial Registry (ChiCTR2400083215).
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