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Maximizing medication safety is a key and increasingly important goal of high-quality health care. One study found that use of prescription medications in older adults increased significantly between 2005 and 2011, including use of highrisk drug classes, increasing the risk of significant drug–drug interactions (1). Most existing descriptions and evaluations of medication safety focus on health-care system-oriented measures including rates of potential interactions, medication discrepancies identified by providers, or readmissions. Although these measures are associated with potential patient harm, they may not align well with patient priorities (2); measures such as patient-reported adverse events or provider errors are frequently not included. Measuring what matters to patients is important because patient engagement, or having patients take an active role in bringing their knowledge, concerns, perspectives, and agenda to their own health care, can improve the effectiveness of medication safety interventions (3,4). However, although patient-reported measurements of health status (that is, any report of the status of a patient’s health condition that comes directly from the patient, without interpretation of the patient’s response by a clinician or anyone else) (5) have become more commonly used, medication safety is rarely measured by asking patients directly. A patientcentered approach to evaluating interventions therefore calls for a broader perspective of medication safety that incorporates (1) patient-reported measures, such as medicationrelated symptoms and burdens and (2) a patient-centered approach to measurement, including addressing long-term issues and those that affect the quality of life. In this perspective, we focus our discussion on a patientcentered approach to measurement and describe commonly used health system–oriented medication safety measures for evaluating interventions and discuss how they can be reframed to better reflect the patient perspective. We contrast these with newer, more patient-centered measure concepts that have not yet been developed into measures to evaluate interventions for improving medication safety and how these might be better incorporated into medication safety initiatives. Finally, we discuss measures that reflect patient-centeredness in medication safety.

Towards a More Patient-Centered Approach to Medication Safety