Systematic review of the use of patients' own medications in acute care institutions.

ABSTRACT

BACKGROUND: Patients' own medications (POM) are medications that patients have obtained in the community setting and bring to the hospital when admitted. The practice of using POMs has not been well studied. OBJECTIVE: To identify benefits, risks and other impacts on the use of POM in hospitals. METHODS: A systematic search of the literature and internet was conducted for articles in the English language dated from 1984 to 2004. PubMed, CINAHL, IPA, and Embase databases were searched with combinations of the following text words patient, own, drug, medication, medicine. References of relevant articles and specific journals were hand-searched. RESULTS: Nineteen primary studies that provided information on the benefits and risks of POMs were identified. Benefits included decreased wastage of POMs, improving the accuracy of admission orders, opportunities for patient counselling and continuity of care between acute and primary care. Hospitals must address liability and workload concerns but may benefit from savings to their drug budget. DISCUSSION: Only a limited number of studies were found that addressed the benefits, risks and costs of using POMs in hospitals. These studies had small sample sizes with limitations in the quality of the study design. Nevertheless, the literature contained examples of benefits to the patient and hospital, as well as assistance with practical issues. Further research is needed to evaluate the benefits and risks of using POMs. Hospital policies should describe identification, storage and documentation procedures to address liability and risk concerns. Implementation of policies to use POMs should include an evaluation component, which could include a comprehensive economic analysis of drug costs and staff workload.