Multi-dose drug dispensing is a challenge across the primary-secondary care interface

Multi-dose drug dispensing (MDDD) signifies that the patient's medicine is packed in disposable bags corresponding to the dose that should be taken. The purpose of the present study was to investigate how a hospital MDDD instruction was followed.

All patients receiving MDDD on admission to the acute medical admission ward at Bispebjerg Hospital in the period from 1 January to 30 June 2010 were prospectively included in the study. An audit of the medication lists and hospital case records covering the period from admission to discharge was performed. A proportion of patients received a post-discharge home visit. An interview in both sectors was carried out to determine whether the instructions had been followed.

Almost 9% of the patients were receiving MDDD on admission. Information on MDDD was recorded in the physician case record for 3.4% of the patients and in the nurse case record for 12.9% of the patients. Changes in MDDD during hospitalization were made for 58.3% of the patients. General practitioners and/or the community pharmacy were notified of changes in MDDD at discharge for 13.6% of the patients. The post-discharge visits and the interview revealed potential issues of concern regarding patient safety.

MDDD is frequent. Identification and registration of MDDD is only performed sporadically. Changes in MDDD are frequent, but they are rarely accompanied by information to the general practitioner or the community pharmacy.

The project was partly funded by the Ministry of Health and Prevention 2009.

The study was approved by the Danish Data Protection Agency.