Bakgrund: Användning av läkemedel ökar och därmed ökar också läkemedelsrelaterade problem. För att patienter ska kunna ha en säker läkemedelsbehandling krävs bland annat korrekt och fullständig läkemedelsinformation. I dagsläget finns det olika informationskällor som patienter använder för att hålla koll på sin läkemedelsbehandling men i många av dem förekommer avvikelser som gör att risken för felmedicinering eller överdosering ökar. Syfte: Syftet med det här arbetet var att undersöka prevalensen av avvikelser i läkemedelslista ”Mina sparade recept på apotek” (MSR), samt att se om vissa läkemedelsgrupper skulle förekomma oftare än andra bland avvikelserna. Även andra variabler, såsom informationskällor som patienter använder för att hålla reda på sin läkemedelsbehandling, avsaknad av receptbelagda läkemedel i MSR och användning av receptfria läkemedel mättes. Metod: Data for studien samlades in genom speciellt utformade läkemedelsintervjuer med patienter på ett öppenvårdsapotek i Sverige under veckorna 3–5 i början av 2021. Patienterna som inkluderades var vuxna patienter som hade åtminstone tre receptbelagda läkemedel i sin MSR och som hämtade ut läkemedel åt sig själva. Innan läkemedelsintervjuerna påbörjade erhölls också ett skriftligt samtycke från alla deltagare. Resultat: Nästan 70 procent av 69 intervjuade patienter hade minst en typ av avvikelse i MSR, därav dubbla och inaktuella recept var vanligaste. Bland avvikelserna var de vanligaste läkemedel för behandling av sjukdomar som rör nervsystemet, hjärta och kretslopp samt matsmältningsorgan och ämnesomsättning. En del av patienterna (35 procent) saknade receptbelagda läkemedel i sin MSR, medan 30 procent av dem uppgav att de använde receptfria läkemedel. Informationskällan som användes av de flesta patienterna för att hålla koll på deras läkemedelsbehandling var just MSR.  Slutsats: Avvikelser i MSR förekommer hos nästan 7 av 10 patienter och de läkemedelsgrupperna som var vanligare bland avvikelser är också läkemedelsgrupper som orsakar mest läkemedelsrelaterade problem. Dessa avvikelser måste åtgärdas eftersom de påverkar patienternas säkerhet och förhoppningsvis kommer implementering av den nya nationella läkemedelslistan (NLL) kunna förbättra situationen för både patienten och hälso- och sjukvårdspersonalen. / Background: The use of medicines has increased in the past few years, which has also led to increased amount of drug-related problems (DRP), such as drug-drug interactions and serious adverse effects which lead to hospitalization. In order to decrease the amount of DRP, the medication lists of individual patients need to be accurate and updated. The most used medication list among those available is the one that is printed out at a pharmacy “My stored prescriptions at pharmacy”.  It is also called “Prescription List” (PL). Even though a lot of patients use the PL, there are a lot of discrepancies in it, such as noncurrent and missing prescriptions, but also prescription duplicates. Aim: The aim of this study was to study the prevalence of discrepancies in the PL, such as noncurrent or duplicate prescriptions, wrong dosage or other unclarities, but also to see if there are some particular drug groups which are more common among the discrepancies. Secondary outcomes that were measured included the amount of missing prescriptions in the PL, as well as the usage of over-the-counter (OTC) medicines and primary information sources that patients use to keep track of their prescriptions. Methods: Data needed for the study was collected by interviewing patients at a local pharmacy. The interview was specially designed to answer to all the outcomes and the patient’s individual PL was also used to identify the discrepancies. In order to be included in the study patients needed to be at least 18 years old, have three or more prescriptions in the national prescription repository (NPR) and pick up their own medication, as well as provide a written consent to participate. Pharmacists that were dispensing patient’s prescriptions were also in charge of the recruitment of patients. Result: Out of the 103 patients that were informed about the study, 69 patients were included. Almost 70 percent of them had at least one type of discrepancy in the PL. The most common discrepancy was prescription duplicates (46 percent), followed by noncurrent prescriptions (44 percent). Drug groups which were common among the discrepancies were the drugs used to treat diseases in the nervous system, cardiovascular system and digestive system (including metabolism). Secondary outcomes showed that 35 percent of the patients had at least one missing prescription in the PL, but also that 30 percent of the patients used OTC medicines, the most common being paracetamol (acetaminophen). The most used information source was the PL with 32 percent of patients using it as their primary information source for their medication therapy. Conclusions: Prescription duplicates and noncurrent prescriptions are frequent in the PL and are a major source of medication errors for patients and health-care workers. Drug groups which where the most common among the discrepancies are also the ones responsible for half of the hospitalizations in Sweden. This implies that they could probably be prevented by improving the PL. The number of the missing prescriptions was quite low. The usage of OTC medicines showed that most of patients used painkillers. These are the drugs that Swedes often overuse and therefore, for future safety, monitoring of OTC sales should be implemented. Although it had 21 percent of inaccuracies, the PL was the most used information source for the patients, which gives the conclusion that the improvement of it is needed as soon as possible in order to prevent and decrease the frequency of DRP.

Background: Discrepancies in patient’s medication list can lead to medication errors which is a major cause of both morbidity and mortality today. The aim of the study was to examine the frequency of discrepancies in the Swedish prescription list “My saved prescriptions” regarding noncurrent treatment, incorrect dosages, double prescriptions, and missing prescriptions. Additionally, the purpose was to examine the type of source of information the patients used regarding their drug treatment.   Methods: Collection of data was conducted through interviews at three different pharmacies over a period of four weeks in Stockholm 2020. Patients 18 years or older with at least three prescribed drugs were asked to participate in the study.   Results: Of 157 patients, 74 patients were included. More than 70% of the patients had one or more discrepancies in their prescription list: a noncurrent, a duplicate or an incorrect dosage. 17.6% had at least one missing prescription. About half of the patients had a noncurrent prescription, which was the most common discrepancy among the patients. More than a third, 35.1%, of the patients used the prescription list as a source of information for their drug treatments. Furthermore, 31.1% of the patients used the drug packaging and 17.6% of them only used their memory. 10.8% of the patients used the medication list from healthcare.  Conclusions: The results suggest that discrepancies were quite common in the prescription list, which can increase the risk of medication errors for patients who use the prescription list as a source of information. The implementation of the Swedish National List (NLL) (launching in 2021) will provide the caregivers, pharmacies, and patients with access to the same information about patient’s prescribed drugs. NLL will hopefully reduce the risk of medication errors and it should lead to a reduced necessity of using several different sources for prescribed drugs.

Bakgrund: Läkemedelshanteringsfel är en ledande orsak till patientskador i hälso- och sjukvårdssystem över hela världen och utgör ett betydande hot mot patientsäkerheten. Läkemedelshanteringsfel är mer vanligt förekommande på intensivvårdsavdelningar än på lägre vårdnivåer. Det dominerande sättet att arbeta med patientsäkerhet inom hälso- och sjukvård är genom avvikelserapportering och analysering av negativa händelser. Vid efterföljande analys och uppföljning av negativa händelser kan en förbättrad patientsäkerhet uppnås. Syfte: Att beskriva innehållet i de avvikelser beträffande läkemedelshanteringsfel, som rapporterats in på en intensivvårdsenhet under år 2023. Metod: En retrospektiv registerstudie. Datamaterialet analyserades med beskrivande statistik och kvalitativ manifest innehållsanalys. Resultat: Fem kategorier framkom under analysförfarandet: Hållbarhet, ordination, iordningställande, administrering och dokumentation. I kategorin administrering identifierades flest avvikelser. Slutsats: Resultatet i denna studie visar övergripande att ingen avvikelse ledde till en vårdskada men att samtliga var undvikbara. Den kategori som innehöll flest avvikelser var Administrering vilket är ett fynd som stärks av tidigare forskning som visar på att administreringsfasen är den mest kritiska i läkemedelshanteringen. Varför avvikelserna inträffade vore intressant att få svar på, något som kan ges som förslag till vidare forskning. Forskare inom säkerhet hävdar dock att det inte alltid är helt lätt att förstå orsakerna eftersom hälso- och sjukvården är ett komplext sociotekniskt system. / Background: Medication errors are a leading cause of patient injury in healthcare systems worldwide and represent a significant threat to patient safety. Medication errors are more common in intensive care units than at lower levels of care. The dominant way of working with patient safety in healthcare is through deviation reporting and analysis of negative events. In subsequent analysis and follow-up of adverse events, improved patient safety can be achieved. Aim: To describe the content of the deviations regarding medication handling errors, which were reported to an intensive care unit during the year 2023. Method: A retrospective registry study. The data material was analyzed with descriptive statistics and qualitative manifest content analysis. Results: Five categories emerged during the analysis procedure: Durability, prescription, preparation, administration and documentation. Most incident reports were identified in the category administration. Conclusion: The results of this study show overall that no deviation led to a medical injury, but that all were avoidable. The category that contained the most deviations was Administration, which is a finding that is reinforced by previous research that shows that the administration phase is the most critical in drug management. Why the deviations occurred would be interesting to get an answer to, something that can be given as a suggestion for further research. However, security researchers argue that it is not always easy to understand the causes because healthcare is a complex socio-technical system.