Managing Multiple Medication Lists in Norwegian Health Care: An Ethnographic Study

As populations age and healthcare systems face increasing complexity, effective medication management is critical for ensuring patient safety and care quality. The medication list is a pivotal element in medication management within the Norwegian healthcare system, playing a crucial role in ensuring patient safety and effective treatment. Through the lens of actor-network theory, this study traces the medication list's journey across various sectors of primary healthcare. Ethnographic fieldwork, including observations in home care services and nursing homes, along with qualitative interviews with general practitioners, nursing home doctors, nurses, and healthcare workers in two Norwegian municipalities and hospitals, highlights the complexity and evolving nature of the medication list.

The medication list not only reflects, but actively participates in shaping different healthcare realities through everyday practices, continuously adapting and shifting. The findings highlight the inherent complexity of medication lists, which often exist in multiple versions across different healthcare settings. Discrepancies between lists—due to lack of synchronization and varying practices—pose significant risks, particularly for patients on polypharmacy, where inaccurate or outdated lists can lead to adverse effects or ineffective treatment. The challenge intensifies when different segments of the healthcare system must communicate and transfer a patient’s medication information, frequently resulting in inconsistencies. The national response—a digital medication list—aims to streamline this process, yet risks remain. Institutions may still develop their own localized solutions, leading to fragmentation and the potential for the national list to become an illusion rather than a unified tool.

This research underscores the importance of understanding the dynamic role of the medication list in the broader context of healthcare communication, revealing both its potential and the challenges.