The Swedish National Pharmacy Register.

Apoteket AB and School of Pure and Applied Natural Sciences, University of Kalmar, Kalmar, Sweden.
Studies in health technology and informatics 02/2007; 129(Pt 1):345-9. DOI: 10.3233/978-1-58603-774-1-345
Source: PubMed

ABSTRACT To achieve a safer future prescribing, the Swedish government has introduced a mandatory registration of all drugs dispensed at pharmacies. The medication history in the register may be accessed online by registered individuals, prescribers and pharmacists. After 15 months of action, the prevalence of individuals with dispensed drugs in the Swedish population was 71.0% (6,424,487/9,047,752); women 78.8% and men 63.1%. The incidence rate for individuals with dispensed drugs was estimated as 12.4 (1,000*111,960/9,047,752) per month and 1, 000 inhabitants. The mean number of dispensed prescriptions was 12.1 (median 6, Q1-Q3 2-15) per individual. For the elderly (age group 80-89), the mean number of dispensed prescriptions was 27.8 during the study period (median 24,Q1-Q3 13-38); women 28.8 and men 26.1. When introducing a National Pharmacy Register, containing personal drug information for the majority of the population, issues on security, confidentiality and ethics have to be taken into consideration. The lack of widespread secure digital signatures in health care may delay general availability. To clinically evaluate individual medication history, the relatively high prevalence of dispensed drugs in the population, seems to justify the National Pharmacy Register.

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Available from: Bengt Astrand, Sep 27, 2015
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    • "Since July 1, 2005, all prescriptions filled at pharmacies in Sweden are stored in the National Pharmacy Register [14]. This does not include over-the-counter sales, which include some analgesics such as paracetamol and some of the non-steroidal anti-inflammatory drugs. "
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    ABSTRACT: The pattern of opioid use after skeletal trauma is a neglected topic in pain medicine. The purpose of this study was to analyse the long-term prescriptions of potent opioids among patients with tibial shaft fractures. Data were extracted from the Swedish National Hospital Discharge Register, the National Pharmacy Register, and the Total Population Register, and analysed accordingly. The study period was 2005-2008. We identified 2,571 patients with isolated tibial shaft fractures. Of these, 639 (25%) collected a prescription for opioids after the fracture. The median follow-up time was 17 (interquartile range [IQR] 7-27) months. Most patients with opioid prescriptions after fracture were male (61%) and the median age was 45 (16-97) years. The leading mechanism of injury was fall on the same level (41%). At 6 and 12 months after fracture, 21% (95% CI 17-24) and 14% (11-17) were still being treated with opioids. Multiple Cox regression-analysis (adjusted for age, sex, type of treatment, and mechanism of injury) revealed that older patients (age >50 years) were more likely to end opioid prescriptions (Hazard ratio 1.5 [95% CI 1.3-1.9]). During follow-up, the frequency of patients on moderate and high doses declined. Comparison of the daily morphine equivalent dose among individuals who both had prescriptions during the first 3 months and the 6th month indicated that the majority of these patients (11/14) did not have dose escalations. We did not see any signs in registry-data of major dose escalations over time in patients on potent opioids after tibial shaft fractures.
    BMC Anesthesiology 01/2014; 14(1):4. DOI:10.1186/1471-2253-14-4 · 1.38 Impact Factor
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    • "This information makes it possible to calculate both the number of prescriptions and the number of individual patients receiving medication. In addition, the register includes information on the prescribing doctor’s affiliation [14]. "
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    ABSTRACT: The herpes zoster burden of disease in Sweden is not well investigated. There is no Swedish immunization program to prevent varicella zoster virus infections. A vaccine against herpes zoster and its complications is now available. The aim of this study was to estimate the herpes zoster burden of disease and to establish a pre-vaccination baseline of the minimum incidence of herpes zoster. Data were collected from the Swedish National Health Data Registers including the Patient Register, the Pharmacy Register, and the Cause of Death Register. The herpes zoster burden of disease in Sweden was estimated by analyzing the overall, and age and gender differences in the antiviral prescriptions, hospitalizations and complications during 2006-2010 and mortality during 2006-2009. Annually, 270 per 100,000 persons received antiviral treatment for herpes zoster, and the prescription rate increased with age. It was approximately 50 % higher in females than in males in the age 50+ population (rate ratio 1.39; 95% CI, 1.22 to 1.58). The overall hospitalization rate for herpes zoster was 6.9/100,000 with an approximately three-fold increase for patients over 80 years of age compared to the age 70-79 group. A gender difference in hospitalization rates was observed: 8.1/100,000 in females and 5.6/100,000 in males. Herpes zoster, with a registered complication, was found in about one third of the hospitalized patients and the most common complications involved the peripheral and central nervous systems. Death due to herpes zoster was a rare event. The results of this study demonstrate the significant burden of herpes zoster disease in the pre-zoster vaccination era. A strong correlation with age in the herpes zoster- related incidence, hospitalization, complications, and mortality rates was found. In addition, the study provides further evidence of the female predominance in herpes zoster disease.
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    • "Sometimes, a medical interview was conducted with a close relative instead of the patient. In addition (or otherwise, if an interview could not be conducted), the pharmacist consulted all available pre-admission lists, including drug lists from primary and community care, the national pharmacy register (all drugs dispensed within the past 15 months) [18], and prescription forms from the medication dispensing system ApoDos (a multi-dose system where all medications that the patient should be taking on one occasion are machine-packed together in small, fully labelled plastic bags at a pharmacy dispensing centre and delivered to the patient every second week) [19]. Based on this information, a list with the patient's prescribed medications was documented in the LIMM medication interview questionnaire, part 1 (Additional file 1). "
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    ABSTRACT: An accurate medication list at hospital admission is essential for the evaluation and further treatment of patients. The objective of this study was to describe the frequency, type and predictors of errors in medication history, and to evaluate the extent to which standard care corrects these errors. A descriptive study was carried out in two medical wards in a Swedish hospital using Lund Integrated Medicines Management (LIMM)-based medication reconciliation. A clinical pharmacist identified each patient's most accurate pre-admission medication list by conducting a medication reconciliation process shortly after admission. This list was then compared with the patient's medication list in the hospital medical records. Addition or withdrawal of a drug or changes to the dose or dosage form in the hospital medication list were considered medication discrepancies. Medication discrepancies for which no clinical reason could be identified (unintentional changes) were considered medication history errors. The final study population comprised 670 of 818 eligible patients. At least one medication history error was identified by pharmacists conducting medication reconciliations for 313 of these patients (47%; 95% CI 43-51%). The most common medication error was an omitted drug, followed by a wrong dose. Multivariate logistic regression analysis showed that a higher number of drugs at admission (odds ratio [OR] per 1 drug increase = 1.10; 95% CI 1.06-1.14; p < 0.0001) and the patient living in their own home without any care services (OR = 1.58; 95% CI 1.02-2.45; p = 0.042) were predictors for medication history errors at admission. The results further indicated that standard care by non-pharmacist ward staff had partly corrected the errors in affected patients by four days after admission, but a considerable proportion of the errors made in the initial medication history at admission remained undetected by standard care (OR for medication errors detected by pharmacists' medication reconciliation carried out on days 4-11 compared to days 0-1 = 0.52; 95% CI 0.30-0.91; p=0.021). Clinical pharmacists conducting LIMM-based medication reconciliations have a high potential for correcting errors in medication history for all patients. In an older Swedish population, those prescribed many drugs seem to benefit most from admission medication reconciliation.
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