A multi-layered burden or a right fit? Physicians' perspectives on multidose drug dispensing in Denmark

Multidose drug dispensing (MDD) provides machine-packed, patient-specific dose pouches to improve medication safety and adherence, streamline medication management, and reduce pressure on healthcare systems. Despite the benefits, uptake in Denmark remains lower than in neighbouring countries, even after MDD prescriptions were integrated into the national electronic Shared Medication Record (SMR). This study explores general practitioners' (GPs) and hospital physicians' experiences with MDD following SMR integration.

A qualitative study was conducted through semi-structured interviews with 15 physicians (8 GPs, 7 hospital physicians) from the Capital Region and the North Region in Denmark between November 2022 and May 2023. Data was analysed using systematic text condensation.

Two main code groups with six subgroups were constructed. "A Multi-layered Burden for Physicians", reflects an experience of an increased workload and added complexity resulting from IT challenges, dosing period calculations, and inconsistent communication with pharmacies. "Finding the Right Fit", highlights uncertainty about which patients and medications are suitable for MDD, together with the differentiated roles of healthcare professionals in managing the MDD system. While some physicians considered MDD beneficial for patients with complex needs, others found it unsuitable for those with fluctuating conditions, especially during hospitalisations.

Although MDD offers potential benefits, its practical implementation is constrained by digital, organisational, and interprofessional challenges. Assessing patient suitability is essential, but rather than excluding patients, the findings suggest reconceptualising MDD as a flexible, adaptable system, capable of meeting individual care needs and responding to changing clinical situations.