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Last updated: 27 July, 2023

Strategies that promote medicine safety

Preventing medicine-related problems requires a collaborative approach between all parties involved in the medicine use process (e.g. health organisations, prescribers, pharmacists, nurses, patients). Pharmacists must work with other healthcare professionals, patients and the health organisation they practise in to improve medicine safety. At the health organisation level, medicine safety can be improved by2,5,6,10:

  • using systematic processes to manage medicines
  • promoting effective communication and collaboration between all people involved in managing medicines
  • identifying and taking extra care with high-risk medicines (see High-risk medicines)
  • ensuring that healthcare settings have appropriate human resources (e.g. staff numbers, staff training)
  • using appropriate technology (e.g. for information recording and transfer, and checking medicines; smart pumps)
  • promoting a safe culture for reporting medication errors, near misses and incidents to encourage shared learning about medication errors
  • ensuring adequate clinical decision support (e.g. patient information, medicines information) at the point of care
  • using continuous quality improvement systems.

Pharmacists and medicine safety

Pharmacists play an important role in ensuring and improving medicine safety, regardless of the setting in which they practise (e.g. hospital, community pharmacy, aged care, general practice). This role includes proactively identifying and resolving actual or potential medicine-related problems.11,12

Some of the ways that pharmacists can identify and resolve such problems are by2:

  • recording a patient's best possible medication history (BPMH)
  • reconciling differences between the BPMH and medication orders (especially during transitions between healthcare settings)
  • conducting a medicines review
  • providing medicines information to the patient.

Medication history

Ideally, the patient's current medication history should be documented at presentation, or as early as possible, and before any new medicine is prescribed. One way to achieve this is through completion of a BPMH. The BPMH provides a comprehensive list that describes the patient's actual medicines use, including adherence, any medicine-related problems, and use of non-prescription and complementary medicines.2 Online training in taking a BPMH can be accessed through the NPS MedicineWise website.

The BPMH should be made available at the point of care (e.g. by uploading it as a Pharmacist Shared Medicines List in the patient's My Health Record) to enable medicines reconciliation and continuity of care.

Medicines reconciliation

Medicines reconciliation involves reviewing a patient's current medicines orders against their documented medication history, reconciling any differences that are identified and documenting medicines changes.2 Medicines reconciliation is critically important at transitions between healthcare settings (e.g. patient discharge from hospital to aged care facility) and can reduce medicine errors by 50–94%.13,14

Medicines review

Medicines review aims to identify, prevent and resolve potential medicine-related problems, and optimise health outcomes within the framework of QUM. This can involve opportunistic discussions with a patient about their medicines and response to medicines, review of a patient's medication history during the dispensing process, or more comprehensive review services such as Home Medicines Reviews (HMRs) and Residential Medication Management Reviews (RMMRs).

Medicines information

Providing patients with information about their medicines, including their options, responsibilities and possible risks, allows them to make informed choices about their medicines and adherence to treatment plans.2 Empowering patients and their carers to ask questions about their medicines and considering patients as equal partners can enable them to be fully informed and engaged when making decisions about their health care.10

The communication method for providing medicines information should be tailored for the patient (see Provide counselling). Medicines should be clearly labelled, with directions for use written in a way the patient can easily understand (see Label medicines and Cautionary advisory labels).

Providing patients with a current, accurate medicines list, and supporting them to maintain the list when changes to medicines are made, can minimise medicine-related problems and risk of patient harm.2 An accurate, up-to-date medicines list is especially important at transitions between healthcare settings.

APF and medicine safety

The Australian Pharmaceutical Formulary and Handbook supports pharmacists in their role of ensuring and improving medicine safety. It contains practical, current and evidence-based information and guidance on a wide range of medicine- and pharmacy-specific topics, including dispensing, counselling, compounding and therapeutic management. Using this information as clinical decision support at the point of care will help promote safe and effective use of medicines.