[Formal quality of electronic discharge prescriptions and estimated supply by community pharmacies]

To ensure continuous medication supply after hospital discharge, German hospitals are allowed to issue discharge prescriptions since 2017 with the requirement to issue electronically since 2025. It is known that 44% of those prescriptions are not filled in on the same day; however, it remains unknown whether these delays are caused by the patient, drug shortages, or difficulties in processing the prescription in the community pharmacies as e. g. formal errors of prescriptions. As the latter are reported by surveyed community pharmacies for paperbased prescriptions, we analysed the formal quality of electronic discharge prescriptions. Additionally, we simulated the dispensing process in the community pharmacy to estimate how well discharge prescriptions can be delivered.

We drew a prospective sample of signed electronic discharge prescription from the University Hospital Heidelberg and conducted descriptive analysis: The formal quality was assessed with regard to the validity and eligibility for reimbursement. In a natural experiment, six community pharmacies assessed at least 100 discharge prescriptions regarding whether the medicinal product (a) would have been on stock, (b) could have been delivered by the main pharmaceutical wholesaler, or (c) a partner pharmacy or a different wholesaler, or (d) could not have been supplied within a short period of time.

In total, 484 electronic prescriptions were included (15.10. - 29.11.2024) belonging to 117 patient cases. 479 electronic prescription were documented via central pharmaceutical number and classified as valid as the name of the medicinal product, strength, form of application, amount to be dispensed and dosage were documented. In terms of reimbursement, all prescriptions contained the speciality of the physician and in 79.3% the smallest package size was prescribed. On average, the six community pharmacies assessed 335 [121-380] discharge prescriptions. In 43.5%-60.3% cases the medicinal product would have been on stock (a) and 37.9%-53.6% of prescriptions could have been delivered by the main pharmaceutical wholesaler (4.3 daily tours). The availability did not differ significantly between the pharmacies.

While paperbased discharge prescriptions were described as errorprone, there were no formal errors in the electronic prescriptions analysed that would have disrupted the medication supply. The prescribed medicinal products were avalaible in nearly all cases at least until the next delivery of the main wholesaler.