Läkare, sjuksköterskor, farmaceuter, patienter och patienters anhöriga är alla delar av den kedja som ska se till så att läkemedelsanvändning sker på ett säkert sätt. Så många inblandade och i så många olika sammanhang gör att läkemedelsanvändning kan vara svårt att hantera. 2014 skrevs det ut 102 913 130 recept i Sverige (1). Fram till 2014 hade ca 850 000 felaktiga recept korrigerats av farmaceuter varje år (2). Att korrigera recept är en nödvändig del som ingår i farmaceutens skyldighet och ansvar vilket regleras i svensk lagstiftning (3). Farmaceuten är en del av vårdkedjan som skall tillse att patienten har en korrekt och säker behandling med läkemedel (4). Tillgång till en nationell gemensam läkemedelslista för alla berörda parter, förskrivare, farmaceut, patient och övrig vårdpersonal skulle kanske kunna komma tillrätta med felaktigheter i förskrivningar och därmed öka patientsäkerheten (4). Tidigare studier har genomförts som behandlar läkarens syn på en gemensam lista och även patientens syn på eHälsoarbete vilket till viss del belyser en gemensam lista (5)(6) men inga studier har hittats om hur en gemensam lista kommer att påverka farmaceuternas vardag vilket ett av syftena med detta arbete har varit. För att uppnå syftet genomfördes en enkätundersökning med farmaceuter verksamma på ett antal apotek där de fick delge sina tankar både kring den information om patienters aktuella läkemedel som finns tillgänglig idag, bland annat genom receptdepån och sina tankar kring en nationell gemensam läkemedelslista. Resultat av undersökning gör gällande att det förekommer fel i receptdepån både med avseende på saknad information, felaktigheter i recept och att recept förekommer mer än en gång och att de finns med trots att patienten inte skall använda dem mer. Majoriteten av farmaceuterna var eniga om att en nationell gemensam läkemedelslista skulle hjälpa dem i deras arbete för att öka patientsäkerheten men huruvida den kommer att lösa alla problem som förekommer i receptdepån får framtiden utvisa. / Doctors, nurses, pharmacists, patients and next of kin are all parts of the chain that is needed to make sure that the use of medication is safe and appropriate for the patient. That many people involved and in many different settings can make the use of medication difficult to manage. In the year 2014 there were 102 913 130 prescriptions made out to patients in Sweden. Up to the year 2014 850 000 corrections had been made to prescriptions with faults in them by pharmacists each year. To correct prescriptions is an essential part of the pharmacist’s obligations and responsibility, a responsibility that is regulated in Swedish law. The pharmacist is the last part of the chain that has the possibility to adjust anything that is wrong with medications and the use of it before it is in the patient’s own hands. The access to a nationally shared medication list for all involved parties might solve some of the problems that faces the responsible parties when it comes to dealing with patients and their new and ongoing medications and in that way be able to increase the safety around mediation for the patient in need. Although the survey conducted as part of this paper focuses on pharmacists the background tries to explain in what way the different professions come in contact with medicines and how they would perhaps benefit from a shared list. The paper also tries to give a little insight to what kind of problems there could be related to prescriptions. In Sweden we have come a rather long way in the use of computers and the use of internet in the field of eHealth compared to other countries. The paper tries to show how the problem surrounding prescription of medicine is handled in the other countries of Scandinavia. Earlier studies have been conducted that looks at shared lists from the doctors view and also studies have been conducted that looks upon eHealth for patients partly in view of shared medication lists. No studies have been found that looks specifically at how pharmacists feel about it and how such a list would benefit them in their work to secure patient safety, hence this paper. In order to reach the papers purpose a survey was performed with pharmacists employed at different pharmacies in the southern part of Sweden. The result of the survey showed that there are indeed problems with prescriptions in the prescription repository and the majority of the pharmacists agreed that a shared medication list could help them in their work to secure patient safety when releasing prescribed medication. Although the pharmacist agreed for the most part in the benefits of such a list they did not know if it would solve all problems, which is for the future to decide.

Impact on accuracy in elderly patients’ medication list, introducing pharmacy-led medical reconciliation at the Emergency department in a Swedish hospital. Background and objective: Discrepancies in patients‘ medication list is a well-known problem and contribute to preventable medication errors. Medication errors could increase morbidity and mortality and are cost-driving to the Health Care System. The primary objective was to investigate if a pharmacist-led medical reconciliation at the Emergency department could increase the accuracy in medication lists for patients at the age of 75 years and older, with five or more drugs in their initial medication list. The second objective was to categorize the discrepancies and the drugs causing them. Study design: Intervention study with retrospective control group. In the intervention group, patients received a medical reconciliation at the Emergency department. In conformity with the retrospective control group, the intervention group also received a medical reconciliation at the hospital ward. All medical reconciliations where pharmacy-led. Discrepancies identified at the medical reconciliation at the ward, were quantified and categorized. Drugs causing discrepancies were categorized by the ATC-index. Descriptive statistics, Chi2-tests and T-tests were performed.  Setting: The Emergency department at the hospital of Kristianstad, four wards at the larger emergency hospital in Kristianstad and two wards at the smaller local hospital in Hässleholm in Sweden Main outcome measures: Numbers of discrepancies in patients ‘medication list identified at medical reconciliation at hospital ward after having an initial medical reconciliation at the Emergency department (intervention) or not (control). Category of discrepancy and ATC-index of the substance causing the discrepancy. Results: In control group (n=65), 170 discrepancies were identified, on average 2,6 discrepancies/medication list. In intervention group (n=65), corresponding figures were 44 and 0,7 respectively. The difference between the groups was significant (p <0,0001).  The main category of discrepancy was “commission of a medication” in the control group and “route of administration” in the intervention group. Paracetamol was the most common drug to cause discrepancies in the control group, zopiklon and furosemid in intervention group. Conclusion: Pharmacy-led medical reconciliation at the Emergency department significantly reduced the number of discrepancies in patients´medication list.