The survey reported here has provided the first snapshot of the use of patients’ own medications in Canadian health care institutions. Of the 86 hospitals that responded, most allowed the use of patients’ own medications, and a small minority actively encouraged their use. Two hospitals did not allow the use of any patients’ own medications. The primary objective for using these drugs was to maintain the patient’s thera­py with a nonstocked or nonformulary drug. Cost sav­ings were cited as the main advantage, followed by decreased inventory and reduced delays in therapy. The main disadvantages were the potential for medi­cation errors, loss of medications, and the time involved to process these drugs. Many challenges to the development and implementation of policies on patients’ own medications, along with potential solutions, were identified. Being informed about the challenges faced by other institutions should allow hospital managers to improve the success of their own policies.

The findings from this Canadian survey concur with the results of a similar survey conducted in the United States in 1999. In that study of small hospitals (up to 200 beds), 154 responses were received (51% response rate). In the Canadian survey, hospitals with up to 200 beds constituted 36% of respondents. A similar percentage of respondents allowed the use of patients’ own medica­tions (91% in the United States and 98% in Canada), and the majority of use was for nonformulary medications (86% in the United States and 83% in Canada [for nonformulary or nonstocked drugs]). Other types of medications allowed by the US respondents were herbal and nutritional agents (67%) and investigational drugs (50%); the corresponding values from the Canadian survey were 36% for complementary and alternative agents and 55% for investigational and clinical trial drugs. In the US study, patients’ own medications were administered from their original containers by a nurse 80% of the time (75% for the Canadian survey).
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The 2 most common problems identified by US hospitals were medication loss (57%) and errors (18%). In contrast, Canadian pharmacy directors mentioned potential medication errors (51%) more often than loss of medications (32%). This difference may be due to an increasing awareness of medication errors in recent years. In 2003, the Canadian Medication Incident Reporting and Prevention System received funding to improve the reporting of medication incidents and promote safe medication-use systems in Canada.15 As well, the Canadian Adverse Events Study16 was published in May 2004, just months before the survey was disseminated. Respondents from both countries documented that pharmacists were the health care professionals who identified the medications most of the time (60% in the US study, 64% in the Canadian study).