Abstract
BackgroundAccess to medicines information is important when treating patients, yet discrepancies in medication records are common. Many countries are developing shared medication lists across health care providers. These systems can improve information sharing, but little is known about how they affect the need for medication reconciliation. The aim of this study was to investigate whether an electronically Shared Medication List (eSML) reduced discrepancies between medication lists in primary care.MethodsIn 2018, eSML was tested for patients in home care who received multidose drug dispensing (MDD) in Oslo, Norway. We followed this transition from the current paper-based medication list to an eSML. Medication lists from the GP, home care service and community pharmacy were compared 3 months before the implementation and 18 months after. MDD patients in a neighbouring district in Oslo served as a control group.ResultsOne hundred eighty-nine patients were included (100 intervention; 89 control). Discrepancies were reduced from 389 to 122 (p < 0.001) in the intervention group, and from 521 to 503 in the control group (p = 0.734). After the implementation, the share of mutual prescription items increased from 77 to 94%. Missing prescriptions for psycholeptics, analgesics and dietary supplements was reduced the most.ConclusionsThe eSML greatly decreases discrepancies between the GP, home care and pharmacy medication lists, but does not eliminate the need for medication reconciliation.
Highlights
Access to medicines information is important when treating patients, yet discrepancies in medication records are common
This study shows that introduction of a shared medication list significantly reduces the number of discrepancies between the medication lists of the GP, pharmacy, and home care service: the number of discrepancies was reduced by two thirds and the share of patients with discrepancies in their lists decreased from 75 to 56%
This study suggests that an electronically Shared Medication List (eSML) reduces the number of discrepancies between the medication lists of the GP, the home care service and the pharmacy for multidose drug dispensing (MDD) users
Summary
Access to medicines information is important when treating patients, yet discrepancies in medication records are common. A recent Norwegian study shows that primary care nurses, pharmacists and GPs experience many challenges obtaining an accurate medication list. They find the current procedures very time consuming, complex and posing a risk to patient safety [15]. Technology such as e-prescribing, which can increase legibility and completeness of the prescriptions and increase access to medicines information, has been suggested to address these challenges [16, 17]. These systems for sharing medication lists vary between countries, and the scientific evidence on the effects is still limited [19]
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