Use of Patients’ Own Medications in Canadian Hospitals: A National Survey

ABSTRACT Objective: Patients’ own medications are medications that patients have obtained in the community setting and have brought with them to the hospital on admission. How such medications are used in Canadian hospitals is not well understood. The objectives of the study were to determine current practices and policies related to patients’ own medications. Methods: Surveys were sent by e-mail to 166 individual addresses for Canadian hospitals with at least 50 acute care beds. Results: Eighty-six hospitals responded (response rate 52%) (but some hospitals did not answer all questions). Use of patients’ own medications was allowed only when necessary by 89% (76/85) of the hospitals, was actively encouraged by 8% (7/85), and was not allowed by 2% (2/85). The most common types of medications allowed were drugs not included in the hospital’s formulary and those not routinely stocked by the hospital, as well as prepackaged, investigational, and multidose medications. Most hospitals (72% [62/86]) had a policy on patients’ own medications, and 70% (57/82) required a physician’s order to use such medications. The perceived advantages of using patients’ own medications were cost savings (67% [48/72]) and decreased inventory (57% [41/72]). The main disadvantages cited were the potential for medication errors (51% [35/69]), loss of the medications in the hospital (32% [22/69]) and the time required to manage such medications (32% [22/69]). Conclusions: Allowing the use of patients’ own medications was common in the Canadian hospitals that responded to this survey, although respondents did identify some concerns with the practice. To address these concerns, it is recommended that hospitals develop identification, storage, and documentation procedures for patients’ own medications. The costs and benefits of using these medications need further evaluation. RESUME Objectif : Les propres medicaments des patients sont definis comme les medicaments qu’ils ont obtenus dans la communaute et qu’ils ont apportes lors de leur hospitalisation. L’utilisation de ces medicaments dans les hopitaux canadiens demeure obscure. Les objectifs de cette etude sont de determiner les pratiques et les politiques courantes relativement a l’emploi des propres medicaments des patients dans les hopitaux. Methodes : Un sondage a ete envoye par courriel a 166 adresses electroniques individuelles d’hopitaux canadiens d’au moins 50 lits de soins de courte duree. Resultats : En tout, 86 hopitaux ont repondu (taux de reponse de 52 %), bien que certains d’entre eux aient omis des questions. L’utilisation des propres medicaments des patients etait permise uniquement lorsque cela etait necessaire par 89 % (76/85) des hopitaux, etait fortement encouragee par 8% (7/85), et n’etait pas permise par 2 % (2/85). Les propres medicaments des patients le plus souvent autorises etaient ceux non inscrits au formulaire ou que l’hopital ne tenait pas en stock, de meme que les medicaments preemballes, les medicaments de recherche et les medicaments multidoses. La plupart des hopitaux (72 %; 62/86) avaient une politique sur l’utilisation des propres medicaments des patients, et 70 % (57/82) exigeaient une ordonnance du medecin pour utiliser ces medicaments. Les avantages percus de l’utilisation des propres medicaments des patients etaient les economies de couts (67 %; 48/72) et la reduction des stocks (57 %; 41/72). Les principaux desavantages cites etaient le risque d’erreur de medication (51 %; 35/69) et de perte des medicaments dans l’hopital (32 %; 22/69), ainsi que le temps necessaire a la gestion de ces medicaments (32 %; 22/69). Conclusions : L’autorisation d’utiliser les propres medicaments des patients dans les hopitaux canadiens sondes est frequente, quoique les repondants aient souleve certaines inquietudes relativement a cette pratique. Pour apaiser ces inquietudes, on recommande que les hopitaux mettent en place une procedure d’identification, d’entreposage et d’enregistrement des propres medicaments des patients. Les couts et les avantages lies a l’utilisation de ces medicaments doivent etre evalues plus avant.

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