GPs’ prescription routines and cooperation with other healthcare personnel before and after implementation of multidose drug dispensing

Abstract

Background: This study addresses GPs' attitudes towards multidose drug dispensing before and after implementation and their perceived experience of how multidose drug dispensing affects prescription and communication routines for patients in the home care services. This study contributes to a method triangulation with two other studies on the introduction of multidose drug dispensing in Trondheim. Methods: a controlled before-and-after study carried out in Trondheim (intervention) and Tromsø (control). a questionnaire was distributed to all GPs in the two towns in 2005 with a followup questionnaire in 2008. Results: The GPs in Trondheim showed a positive attitude to multidose drug dispensing both before and after the implementation. Increased workload was reported, but still the GPs wanted the system to be continued. Most of the GPs reported a better overview of the patients' medication and a supposed reduction in medication errors. The GPs' prescription-and communication routines were changed only for the multidose drug users and not for the other patients in the home care services. Conclusions: The study supports the results presented in two previous publications according to GPs' positive attitude towards multidose drug dispensing, their better overview of the patients' medications, and improved cooperation with the pharmacy. This study adds to our understanding of prescription routines among GPs and the use of the medication module in the electronic health record.

Drug Treatment in Older People before and after the Transition to a Multi-Dose Drug Dispensing System–A Longitudinal Analysis

“…Some previous studies indicate that an MDD system may reduce medication errors [18], [19] and provide a better overview of a patient’s medication list [20], [21]. Thus, it cannot be excluded that the medication lists in the present study may be appropriate at the individual level, although extended and more often potentially harmful according to indicators.…”

“…Indeed, MDD was the main risk factors for medication errors at transitions in healthcare [25]. Furthermore, the experienced increased workload for general practitioners for prescribing within such systems [20], [21] may affect prescribing practices and reduce reconsideration of drug treatment.…”

Prevalence of suboptimal drug treatment in patients with and without multidose drug dispensing—a cross-sectional study

“…Some previous studies indicate that an MDD system including medication records may provide a better overview of the patients’ medication lists and reduce medication errors [15–17]. In addition, the initiation of MDD may be preceded by a medication review in order to improve drug treatment quality [18].…”

“…In such systems, the prescriber has to document drug treatment in both systems [20] and may experience an increased workload [16, 17]. This may affect prescribing practices and reduce reconsideration of drug treatment, and consequently have an effect on treatment quality.…”

Multidosetjeneste for hjemmeboende – brukerneserfaringer og behov for nye løsninger

“…Det viktigste formålet med multidose er å øke sannsynligheten for at personer som bruker flere ulike legemidler får riktige legemidler til riktig tid (Hjelle, 2015). Bestillingssystemet for multidose har redusert forekomsten av avvik (Wekre et al, 2012(Wekre et al, , 2010, og i tillegg er multidose ansett som et tidsbesparende alternativ (Hageler, 2015). Kommunefarmasøyten i Trondheim fant at håndtering av legemidler i sykehjem går raskere med multidose enn med manuell dosering i ukesdosett, uten påvist risiko for flere feil (Hageler, 2015), mens en kunnskapsoppsummering fra Skandinavia viser at multidose kan senke kvaliteten på legemiddelbehandling som en følge av manglende samhandling (Halvorsen & Granås, 2012).…”