Implementation of a shared medication list in primary care - a controlled pre-post study of medication discrepancies

Abstract

Background: Access to medicines information is important when treating patients, yet discrepancies in medication records are common. Many countries are developing shared medication lists across health care providers. These systems can improve information sharing, but little is known about how they affect the need for medication reconciliation. The aim of this study was to investigate whether an electronically Shared Medication List (eSML) reduced discrepancies between medication lists in primary care.

Methods: In 2018, eSML was tested for patients in home care who received multidose drug dispensing (MDD) in Oslo, Norway. We followed this transition from the current paper-based medication list to an eSML. Medication lists from the GP, home care service and community pharmacy were compared 3 months before the implementation and 18 months after. MDD patients in a neighbouring district in Oslo served as a control group.

Results: One hundred eighty-nine patients were included (100 intervention; 89 control). Discrepancies were reduced from 389 to 122 (p < 0.001) in the intervention group, and from 521 to 503 in the control group (p = 0.734). After the implementation, the share of mutual prescription items increased from 77 to 94%. Missing prescriptions for psycholeptics, analgesics and dietary supplements was reduced the most.

Conclusions: The eSML greatly decreases discrepancies between the GP, home care and pharmacy medication lists, but does not eliminate the need for medication reconciliation.

Keywords: E-health; E-medicines management; Medication discrepancies; Medication reconciliation; Multidose drug dispensing; Primary care; Shared medication list.