Aktuella recept? : En intervjustudie om avvikelser i apotekens receptlistor

Sammanfattning: Background: Around two thirds of the Swedish population use prescripted drugs and usage usually increases with age. Along with increasing age and more prescriptions, the risk of side effects and interactions also increases. Drug-related problems (DRP) causes suffering of inviduals and is also associated with high costs for the society. A previous study has shown that discrepancies in prescription lists are common, which can pose a significant risk of DRP. Accurate drug information increases the chance that the right medicine will be dispensed at the right time, at the right dose, to the right person and that the patient will use it correctly. Aim: The aim of this study was to investigate the presence of discrepancies in prescription lists, defined as outdated prescriptions, duplicates, incorrect dosage and uncertainty, as well as the extent to which prescriptions for current drug treatment were missing. The secondary purpose was to investigate how sure pharmacy customers felt about their medicine – what medicine to use, how to use them and why. Methods: An interview study was conducted at nine pharmacies, in six different cities in Sweden, during spring 2021. Inclusion criteria were pharmacy customers over the age of 18 who picked up medicines for themselves, spoke Swedish and had three or more prescriptions. Exclusion criteria were customer with multidose-dispensed drugs (ApoDos) or an agent. An interview guide was used together with a printing of the prescription list for pharmaceutical review. Written informed consent was obtained from the participants before the start of the interview. Result: 485 people met the inclusion criteria. The loss was 232 people (48 %). Out of 253 participants, 63,2 % had at least one discrepancy in prescription list and the number of discrepancies ranged from 1-16 per person for these. Only 36,8 % of participants had a completely correct prescription list. Out of a total of 2084 prescriptions, 463 prescriptions (22 %) had some form of discrepancy, the most common of which was “Duplicates” (n = 195) and “Outdated prescription” (n = 193), followed by “Incorrect dosage” (n = 71) and “Uncertainty” (n = 4). 86 participants (34 %) lacked a prescription for current treatment, a total of 131 prescriptions were missing. Participants felt very confident about their drug use. 83,8 % felt completely confident about which medicines to use, 95,3 % about how to use them and 88,9 % about why. Conclusions: The conclusions that can be drawn from this study are that discrepancies are quite common in the prescription lists as discrepancies were found in every fifth prescription. The most frequent discrepancies were outdated prescriptions and duplicates thus increasing the risk for medication errors and/or overdoses. Around one third of the participants were missing some prescriptions. These discrepancies in prescription lists can be a huge problem and also a safety issue if the patients rely solely on this information in the lists. Moreover, this study also showed that, in spite of the discrepancies, the patients felt very sure about which medicine to use and also how to use them and why.