Assessing accuracy of an electronic provincial medication repository

Background: Jurisdictional drug information systems are being implemented in many regions around the world. British Columbia, Canada has had a provincial medication dispensing record, PharmaNet, system since 1995. Little is known about how accurately PharmaNet reflects actual medication usage. Methods: This prospective, multi-centre study compared pharmacist collected Best Possible Medication Histories (BPMH) to PharmaNet profiles to assess accuracy of the PharmaNet profiles for patients receiving a BPMH as part of clinical care. A review panel examined the anonymized BPMHs and discrepancies to estimate clinical significance of discrepancies. Results: 16% of medication profiles were accurate, with 48% of the discrepant profiles considered potentially clinically significant by the clinical review panel. Cardiac medications tended to be more accurate (e. g. ramipril was accurate >90% of the time), while insulin, warfarin, salbutamol and pain relief medications were often inaccurate (80-85% of the time). 1215 sequential BPMHs were collected and reviewed for this study. Conclusions: The PharmaNet medication repository has a low accuracy and should be used in conjunction with other sources for medication histories for clinical or research purposes. This finding is consistent with other, smaller medication repository accuracy studies in other jurisdictions. Our study highlights specific medications that tend to be lower in accuracy.