Multidose drug dispensing in home care services: Impact of a shared medication list on medication safety

Multidose drug dispensing (MDD) is machine dispensed medications into unit bags, a system commonly used in home care services. Currently, an electronic prescribing system for MDD is being piloted. We find that MDD patients use several regular medications, many of which are potentially inappropriate. Further, we find that one of the benefits of the MDD system is increased access to information about the patients’ prescribed medication. This increased overview enables pharmacists to identify a range of problems with the MDD prescriptions, including some that would be difficult to detect on ordinary prescriptions. With the new electronic system, the overview of prescribed medications is further improved and changes in medication treatment is initiated faster in the MDD bags. However, the pharmacists described how increased access to information and more actors who could prescribe for the patients increased the need for clarifications regarding the current and correct treatment. For the electronic prescribing system to achieve its goals of increasing medication safety there is a need to define the responsibilities of all the health personnel involved in the medication management, along with the responsibility of reviewing the entire medication treatment of a patient, including those medications prescribed by other physicians.