Hospital Patients Keep Own Medication: Less Waste & More Control

For decades, hospital medication protocols have often involved a shift from a patient’s regular prescriptions to alternatives managed by the hospital pharmacy during their stay. This process, while intended to ensure safety and availability, can be complex and prone to errors. Now, a growing movement within several Dutch hospitals is challenging this long-held practice, advocating for patients to continue using their own medications whenever possible.

A Shift in Approach to Hospital Pharmacy

Professor Jeroen Derijks, a hospital pharmacist at Jeroen Bosch Hospital in Den Bosch and professor at Tilburg University, describes the current system as “illogical” given the short duration of most hospital stays. Typically, pharmacy assistants map a patient’s medication use, checking for availability of prescribed drugs. Sometimes the same medication is available, but often an alternative with a different active ingredient is substituted. Even when it’s the same drug, it frequently comes in different packaging with a new barcode, creating confusion.

Did You Know? Hospitals are now finding that allowing patients to continue their own medications leads to a 40 percent reduction in medication waste.

Currently, medication is typically switched for patients staying multiple days. Those undergoing day treatments are already permitted to use their own medications, and exceptions exist for specific cases like asthma inhalers. The impetus for change stems from the time-consuming nature of switching medications, the increased risk of errors, and the loss of patient control over their own healthcare.

Reducing Waste and Improving Efficiency

The shift to allowing patients to continue their own medications isn’t just about patient autonomy; it’s also about efficiency. Experiments have shown that using a patient’s existing medications saves over five hours of staff time for every 100 patients. This time savings is expected to increase when patients manage their medications throughout their entire hospital stay. Professor Derijks is currently researching the effects of this approach on a larger scale.

Initially, concerns were raised about potential “economic offenses” – the possibility of double billing if both hospital and patient-supplied medications were used. However, Professor Derijks demonstrated that this concern was unfounded. He calculated that providing a new box of medication when a patient’s supply runs out costs hospitals a net 3.50 euros per patient per admission, representing minimal financial impact.

Expert Insight: The resistance to this change highlights a common challenge in healthcare: balancing established protocols with innovations that prioritize patient well-being and resource optimization. Overcoming ingrained practices requires demonstrating clear benefits and addressing legitimate concerns about safety and financial implications.

Another hurdle was the reluctance of nurses to relinquish control over medication management, fearing patients might not adhere to their schedules. However, a survey of 35 hospitals revealed that 60 percent of patients are perfectly capable of managing their own medications. Professor Derijks emphasizes that nurses still play a crucial role in verifying medication adherence and providing support when needed, ensuring information is relayed to the patient’s primary care physician.

Expanding Implementation and Future Outlook

Six hospitals – Jeroen Bosch Hospital, UMC Groningen, Radboudumc, Sint Maartenskliniek, Elisabeth-TweeSteden Ziekenhuis, and Maastricht UMC+ – are already adapting their procedures. The changes are being implemented gradually, department by department, with Professor Derijks anticipating full adoption within two years.

The Dutch Association of Hospital Pharmacists (NVZA) supports this initiative, with board member Jennifer Korporaal stating that it aligns with the organization’s commitment to patient self-management and safety. The NVZA has even developed a toolkit, in collaboration with Radboudumc researchers, to assist hospital pharmacists in implementing this new approach.

Professor Derijks notes that this approach isn’t limited to planned admissions. He points out that even patients arriving by ambulance often have family members who visit shortly after, bringing essential items like toothbrushes – and potentially, their medications.

Frequently Asked Questions

What is the primary benefit of allowing patients to use their own medications in the hospital?

The primary benefit is a reduction in medication waste, with experiments showing a 40 percent decrease. It also saves staff time and gives patients more control over their healthcare.

Were there concerns about the cost of this new approach?

Initially, there were concerns about double billing, but Professor Derijks demonstrated that the cost to the hospital is minimal – approximately 3.50 euros per patient per admission – when a new box of medication is provided if a patient’s supply runs out.

How confident are healthcare professionals in patients’ ability to manage their own medications?

A survey of 35 hospitals found that 60 percent of patients are capable of managing their own medications effectively, but nurses are still expected to verify adherence and provide support when needed.

What impact will this shift have on the future of hospital care?