Finnish Experts Reach Consensus on Medication Documentation Standards

In a significant step toward harmonizing healthcare practices in Finland, a Delphi study has established a strong consensus among regional experts on the specific contents and documentation requirements for medication optimization services. The research, published in BMC Health Services Research, focused on aligning regional practices within one of the country’s new wellbeing services counties with the national patient information documentation guideline. The study aimed to standardize how medication reconciliation, prescription review, and medication review are recorded in a regional electronic health record system, addressing the World Health Organization’s identification of inconsistent medication documentation as a major risk factor for patient safety.

The study was conducted in one of the 21 wellbeing services counties established in 2023 as part of a major social and health systems reform in Finland. This specific county covers a population of 210,000 residents. To determine the appropriate documentation standards, the researchers utilized the Delphi consensus method, which involves iterative rounds of expert feedback to reach a group opinion. The process included two rounds of surveys conducted in 2024 with an interprofessional expert panel. The panel consisted of 20 practicing professionals, including five physicians, five nurses, and ten pharmacists, ensuring a diverse perspective on clinical medication management.

The primary objective of the study was to define the precise contents of medication reconciliation, prescription review, and medication review practices that should be documented in the regional electronic health record system. The first round of the Delphi survey was based on the existing national patient information documentation guideline, as well as an inventory of national and international practices. The researchers set a preset consensus rate of 80%, meaning that at least 80% of the panel members had to agree on an item for it to be included in the final set of documentation standards. This methodical approach allowed for the refinement of documentation requirements through expert debate and consensus building.

The results of the study demonstrated a high level of agreement among the experts. Consensus was reached on a total of 147 predetermined and expert-suggested items. These items were categorized into three main areas of medication optimization. Specifically, 39 items related to the contents and documentation of medication reconciliations, 32 items pertained to prescription reviews, and 76 items were dedicated to medication reviews.

Throughout the study, the consensus and response rates remained high, with an overall response rate of 90%. However, the study also noted greater variation in opinions when defining the specific patient groups to whom these medication optimization interventions should be targeted.

The findings of the Delphi study were consistent with the national documentation guideline, as well as international recommendations and previous research in the field. The authors concluded that the Delphi method proved to be a feasible and effective approach for supporting the regional implementation of national documentation guidelines.

Despite the successful establishment of consensus on documentation contents, the authors emphasized that further research is needed to evaluate the actual implementation process. It is crucial to assess the impact of these harmonized practices on medication safety and effectiveness in real-world clinical settings.

Subject of Research: Aligning regional medication optimization practices and documentation with the national patient information documentation guideline in Finland: a Delphi study

Article Title: Aligning regional medication optimization practices and documentation with the national patient information documentation guideline in Finland: a Delphi study

Article References: Lindholm, T., Sulkava-Kuusisto, S.-S., Airaksinen, M., Heikkilä, A., Nurminen, P., Lias, N., Nurmi, H., Kvarnström, K., Schepel, L., & Suvikas-Peltonen, E. (2026). Aligning regional medication optimization practices and documentation with the national patient information documentation guideline in Finland: a Delphi study. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15943-8

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15943-8

Keywords: Aligning, regional, medication, optimization, practices, documentation, national, patient, information, guideline, Finland, Delphi