Use of patients' own medications in small hospitals

The prevalence, management, and adverse events associated with the use of a patient's personal medications in hospitals were studied. A questionnaire comprised of 17 questions was mailed in November 1999 to the pharmacy directors of a random sample of 300 small (< or = 200-bed capacity) hospitals selected from the American Hospital Association 1999 membership directory. A follow-up mailing was sent to nonrespondents in early December 1999. The total usable response rate was 54.6%. The mean bed capacity was 76.6, and 70.8% of facilities had < or = 100 beds. Most facilities provided acute care, were nonprofit organizations, and were located in rural areas. A majority (90%) of the pharmacy directors surveyed allowed patients to use their own medications in the hospital. Elderly patients were most likely to bring their personal medications to use in the hospital, and pharmacists were the health professionals most likely to identify patients' personal medications. Circumstances in which patients were allowed to use their own medication, provided there was a physician's order, included prepackaged courses of therapy or antimicrobial courses and nonformulary medications, excluding controlled substances. Loss of personal medication and medication errors were the most frequently identified problems with allowing patients to use personal medications. Most small hospitals allowed the use of patients' personal medications; however, there was a wide variation in the circumstances for which the use of these medications was allowed.