Electronically supported co-operation of physicians and pharmacists to improve medication safety in the ambulatory setting: The “Arzneimittelinitiative Sachsen-Thüringen” (ARMIN)

Abstract

In Germany, the number of drugs dispensed, prescription as well as drugs that are sold without a prescription (over-the-counter drugs), is rising continuously. As a consequence, the proportion of patients with polymedication and the risk for adverse drug events is rising as well. The ABDA – Federal Union of German Associations of Pharmacists and the Federal Association of Statutory Health Insurance Physicians developed a comprehensive concept based on an interdisciplinary approach. Overall, the concept aims to improve both the effectiveness and safety of pharmacotherapy. The program consists of three components: (1) preferred generic prescribing (instead of brand name products), (2) preferred prescribing of first-line drugs according to a medication catalogue, and (3) medication management (MM). In ARMIN (Arzneimittelinitiative Sachsen-Thüringen), a contract signed in 2014, this concept was implemented for the first time. Datasets were developed and integrated into the local software of physicians and pharmacies to establish the prescription of active ingredients and dispensing the appropriate product as well as the medication catalogue. For MM, processes and responsibilities were developed as well as a technical infrastructure to enable an electronic exchange of patients’ medication data. By December 2017, 546 physicians and 969 pharmacists participated in ARMIN, of which 297 physicians and 285 pharmacists were technically able to offer MM, and approximately 3200 patients had signed up for the MM service. In ARMIN, a promising interdisciplinary concept has been developed and implemented. Defining responsibilities and integrating the components into the local software of the physicians and pharmacists facilitated implementation. Future evaluation will show to what extent this concept can contribute to medication safety.