OBJECTIVES Excessive polypharmacy and duplicate medications not only pose a risk to patients but also place a huge burden on National Health Insurance (NHI) resources in Taiwan. This interventional study was designed and carried out in a regional hospital to reduce excessive polypharmacy and duplicate prescriptions, enhance medication safety in patients and to avoid unnecessary waste of NHI resources.

METHODS Based on the NHI PharmaCloud System, three strategies were carried out in collaboration with in-hospital information technology department. First, we strengthened the act of our medical professionals to check the NHI PharmaCloud System and promoted patients’ willingness to sign informed consent which allowed their medication records to be reviewed, by conducting educations and slogan campaigns. Second, we shortened the refill day of refillable prescription from 10 to 5 days. Third, a computer program was written to enable patients’ inter-hospitals medications (retrieved from NHI PharmaCloud System) and their newest prescriptions at our hospital to be integrated and compared. The remaining number of days of each drug on the newest prescriptions was displayed, and an alert prompt would appear on the computer screens of the physicians and pharmacists involved in managing the prescriptions.

RESULTS After completing the first intervention, patients who refuse to sign informed consent to allow reviewing of their medication records dropped from 4.31% (January to March, 2016) to 1.4% (July to September, 2018) and patients’ recognition of the NHI PharmaCloud System increased from 68.6% to 100%. The cost of medication duplication decreased from 6.52‱ (July to September, 2016) to 3.68‱ (July to September, 2018), i.e. from NT69147 to NT45416, and days of duplicated prescription decreased from 7197 to 6349 days after the second and third interventions were completed.

CONCLUSIONS Our interventions were able to reduce duplicate prescriptions, enhance medication safety in patients and finally, prevented a waste in NHI resources.