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Multidose drug dispensing and discrepancies between medication records
Liv Johanne Wekre1, Olav Spigset, Olav Sletvold
1Department of Community Medicine and General Practice, Norwegian University of Science and Technology NTNU, MTFS, Trondheim, Norway. liv.j.wekre@ntnu.no
Quality & Safety in Health Care
|August 7, 2010
Summary
Multidose drug dispensing (MDD) implementation in elderly outpatients significantly reduced medication record discrepancies and associated health risks. This improvement stemmed from enhanced medication process focus and routine changes, not solely MDD itself.
Area of Science:
- Geriatric Pharmacy
- Medication Management
- Patient Safety
Background:
- Medication record discrepancies pose risks for elderly outpatients.
- General practitioners (GPs) and community home-care services often have differing medication records.
- Multidose drug dispensing (MDD) is a system for organizing patient medications.
Purpose of the Study:
- To evaluate if implementing multidose drug dispensing (MDD) reduces medication record discrepancies in elderly outpatients.
- To assess changes in medication record discrepancies between GPs and community home-care services post-MDD implementation.
Main Methods:
- A controlled follow-up study with a paired design of patient medication records was conducted.
- Medication records from home care units and GPs were reviewed for discrepancies.
- Discrepancies were classified by potential harm using a risk score system.
Main Results:
- A significant reduction in medication record discrepancies was observed, from 203 to 133 (p<0.001).
- The total risk score associated with discrepancies decreased from 308 to 181 (p<0.001).
- Reductions in discrepancies were significant for both MDD-suitable and non-MDD drugs (39% and 31% respectively).
Conclusions:
- Implementation of MDD was associated with a decrease in health risks stemming from medication record discrepancies.
- The positive effects were likely driven by changes in routines and increased focus on the medication process.
- Further research may be needed to isolate the specific impact of MDD versus process improvements.
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