Impact of electronic prescribing on medication changes in users of multidose drug dispensing

Purpose: To investigate the number and type of prescription modifications after introducing e-prescribing for multidose drug dispensing (MDD) users. Methods: A longitudinal study using dispensing records from the main MDD supplier in Norway from June 2012 to August 2023. The study included 1522 MDD users with complete data from 24 weeks before and 24 weeks after the implementation. The main outcome measures were the number and type of prescription modifications. Results: In total, there was a 175 % increase in the frequency of prescription modifications, with 15.9 % of patients experiencing prescription alterations every two weeks, compared to 5.7 % before the intervention. Modifications were categorized into administrative and treatment changes. Administrative changes increased by 300 %, while treatment changes (including newly prescribed medications, discontinued medications, and dose adjustments) increased by 60 %. The proportion of patients with no prescription modifications throughout the 24 weeks decreased from 58.1 % to 26.2 % following the implementation of e-prescribing. Conclusion: Transitioning to an e-prescribing system is associated with more frequent modifications to patients' prescriptions. More frequent treatment changes can potentially improve medication safety and accuracy of the medication lists, but the major increase in administrative changes can also increase the workload of involved health care personnel.