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Original research
Multidose drug dispensing and discrepancies between medication records
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  1. Liv Johanne Wekre1,2,3,
  2. Olav Spigset4,5,
  3. Olav Sletvold6,7,
  4. Janne Kutschera Sund2,
  5. Anders Grimsmo1,3
  1. 1Department of Community Medicine and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
  2. 2Central Norway Hospital Pharmacy Trust, Trondheim, Norway
  3. 3Norwegian EHR Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
  4. 4Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
  5. 5Department of Clinical Pharmacology, St Olav University Hospital, Trondheim, Norway
  6. 6Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
  7. 7Section of Geriatrics, Department of Internal Medicine, St Olav University Hospital, Trondheim, Norway
  1. Correspondence to Mrs Liv Johanne Wekre, Department of Community Medicine and General Practice, Norwegian University of Science and Technology (NTNU), MTFS, Trondheim, Norway; liv.j.wekre{at}ntnu.no

Abstract

Background The objective of this study was to investigate whether implementation of multidose drug dispensing (MDD) for elderly outpatients is associated with a change in the number of discrepancies in the medication record at the general practitioners (GPs) and at the community home-care services.

Methods A controlled follow-up study with paired design of patients' medication records was performed during implementation of MDD. Medication records from the home care units and from the GPs were reviewed, and the discrepancies were noted. The discrepancies were rated into four classes based upon the potential harm, and a risk score system was applied, giving the potentially most harmful discrepancies the highest score.

Results Medication records from 59 patients with a mean age of 80 years were included. The number of discrepancies was reduced from 203 to 133 (p<0.001), and the total risk score decreased from 308 to 181 (p<0.001) after the implementation of MDD. For both drugs subject to MDD and drugs not suitable for MDD, the reductions in discrepancies were significant (39% and 31% reduction respectively).

Conclusions Calculated health risk due to discrepancies between the medication records from the home-care service and from the GPs decreased during the time of implementation of the MDD system. It seems likely that most of the positive effect was caused by the change in routines and enhanced focus on the medication process rather than by MDD per se.

  • Multidose drug dispensing
  • medication records
  • drug safety
  • general practice
  • home-care services
  • medication error

https://doi.org/10.1136/qshc.2009.038745

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    Footnotes

    • Funding Liaison Committee between the Central Norway Regional Health Authority (RHA) and the Norwegian University of Science and Technology (NTNU).

    • Competing interests None.

    • Patient consent Obtained.

    • Ethics approval Ethics approval was provided by the Regional Committee for Medical Research Ethics (REK) and the Norwegian Data Inspectorate (NSD).

    • Provenance and peer review Not commissioned; externally peer reviewed.