Sammanfattning
BACKGROUND : To prevent medication errors, community homecare services (CHS) increasingly use multi-dose packaged medicines (MDPM) for their clients. More knowledge is needed on how MDPM affects routines and quality of medication handling in the CHS.
MATERIAL AND METHODS : Four CHS districts in a Norwegian community (27 GPs, 121 nurses) participated in the study. Structured questionnaires with some open-ended questions were used during interviews. The questionnaire focused on experience and satisfaction with MDPM as compared to the old system, and on how the MDPM had influenced collaboration between different categories of health personnel.
RESULTS : With the MDP-system most nurses and GPs felt that medication control had become easier (CHS 76%, GPs 56%; p = 0.03) and that routines had improved (CHS 84%, GPs 52%; p < 0.001) with the MDP-system. Three of four GPs felt more confident than before about patients receiving the medication they had prescribed (CHS 73%, GPs 78%; p = 0.7). 44% of the GPs felt that they spent more time on prescribing medication with MDPM.
INTERPRETATION : MDPM was generally found to improve routines, the quality of medication handling and medication safety. GPs were less content with the arrangement than nurses, probably because they had to collaborate with more CHS districts with different routines for exchanging information. When introducing MDPM in the CHS, explicit and definite orders of responsibility should be established as well as uniform collaboration routines between the GPs, the CHS and the MDPM-providers.