1. Summary in English

In 2024, the County Governors conducted a nationwide supervision of the use of electronic medication dispensers for elderly people living at home. The purpose of the supervision was to help ensure that elderly individuals receive safe and effective medication management.

This supervision is part of an initiative by the Norwegian Board of Health Supervision, targeting health and care services for elderly people living at home during the period 2024–2027.

Medication management includes all tasks related to medication, from the time it is prescribed or requested until it is dispensed or, if necessary, discarded. The supervision focused specifically on the dispensing and administration of medication.

Elderly individuals living at home who need assistance with administering their medication are entitled to health care services from the municipality. Electronic medication dispensers can be one way to meet this need. The use of such dispensers has increased significantly in recent years, from nearly 9,300 users in 2023 to over 11,000 users in 2024.

To assess whether municipalities facilitate and monitor the safe use of medicine dispensers, the County Governors examined municipal practices related to:

• individual assessment of medication dispensers as a measure,
• training provided to patients in the use of medication dispensers, and
• monitoring of medication dispensers as a measure.

Main findings from the supervision

• A great deal of good work is being done in home care services, and patients are generally satisfied with the use of medication dispensers.
• Medication dispensers can enhance patient safety, but they also involve risks that municipalities must address through planning, implementation, evaluation, and correction of services.
• There are shortcomings in how municipalities facilitate sound professional practice.
• Municipalities lack sufficient oversight of their own services.

Lessons learned from the supervision

Medication management is an area where errors can have serious consequences for patients. Municipalities must reduce the risk of such errors through effective management and control. The supervision highlights several learning points that the Norwegian Board of Health Supervision believes can support quality improvement efforts in other municipalities as well. These learning points aim to promote systematic and sound practices to:

• assess whether medication dispensers are appropriate for each individual patient,
• enable patients to use the medication dispenser correctly, and
• monitor whether the measure ensures safe and effective medication administration.

We encourage all municipalities to reflect on how they can improve their practices. The following questions and statements may serve as a starting point for reflection and evaluation:

• Do we offer medication dispensers when appropriate, and do we ensure that patients receive the necessary training?
• Have we provided employees with training, guidance, and job descriptions that enable them to detect changes in patients?
• Do we ensure that employees have access to relevant, up-to-date information about patients?
• Do we have control activities that provide insight into whether patients are receiving safe and effective medication administration?
• Do we use experiences and findings from practice to improve our services?