Background Drug tenders and shortages result in drug changes. International studies found that drug changes can adversely affect patient safety and the working procedures of healthcare professionals.1,2 The challenges of drug changes in Danish public hospitals have not previously been studied.

Purpose To identify barriers and facilitators for implementing drug changes due to drug tenders and shortages in Danish public hospitals.

Material and methods Six focus group interviews were conducted at three hospitals in different regions of the country. At each hospital two focus group interviews were conducted, one including physicians and nurses and one including pharmacists and pharmacy technicians, respectively. The focus groups consisted of three to four participants. A semi-structured interview guide was applied and the interviews were audio-recorded, transcribed verbatim and categorised thematically through content analysis.

Results Barriers Identified included: frequent changes of labelling, packages and drug names. Furthermore, implementing drug changes requires extra resources and finance. Technologies such as computerised physician order entry and barcode scanning systems were perceived as potential facilitators, but also as barriers in cases where the quality and implementation of the systems were not adequate. Facilitators included: hospital pharmacy services and lower drug prices. Furthermore recommendations on generic prescription, optimisation of the tendering process and support for drug identification during drug shortages were proposed.
Conclusion This study identified different barriers and facilitators for implementing drug changes. The barriers and facilitators included specific features related to drugs, health care technology as well as to financial and organisational aspects. Future studies should focus on removal of barriers and development and implementation of appropriate facilitators which may indeed improve patient safety and the working procedures of healthcare professionals during drug changes.