Cross-border ePrescription is perceived to improve access to medicines, tools are needed for patient counselling to improve medication safety

The study, published in the journal Research in Social and Administrative Pharmacy, investigates the first experiences of Estonian and Finnish pharmacists with Cross-border ePrescription. 

This study aimed to assess the benefits and potential shortcomings of Cross-border ePrescription by examining the experiences of pharmacists in these two countries. 

The majority of pharmacists had not encountered problems with patient identification when dispensing Cross-border ePrescriptions. Nearly all respondents rated the Cross-border ePrescription system as safe for personal data protection.  

Language barrier the main challenge 

The primary problem reported was the rigidity of the pharmacy Cross-border ePrescription dispensing software, followed by differences in the prescribing practices and availability of the medication.  

The responded pharmacists in both countries found it challenging to counsel patients due to language barriers. Patient counseling is also complicated by the fact that the dosage instructions for the medicine to be dispensed are only in the patient's own language. In addition, pharmacists reported difficulties in monitoring interactions between medicines used by patients with Cross-border ePrescriptions. This is because the pharmacist does not have access to the information on all patient’s medication when dispensing Cross-border ePrescription. 

Addressing language barriers and improving tools for monitoring drug interactions are essential for drug safety and the seamless adoption of Cross-border ePrescription across Europe. 

What is Cross-border ePrescription? 

The European cross-border electronic prescription was first introduced in Estonia and Finland in 2019 and is gradually being implemented across Europe.  

In Finland, you can buy medicines with a Cross-Border ePrescription issued either in Estonia, Croatia, Portugal, Poland, Czech Republic and Spain. When you buy medicines with an electronic prescription, you must visit the pharmacy yourself. Bring a photo ID, such as a passport or ID card, to the pharmacy. Medicines classified as narcotics, certain central nervous system affecting drugs, and those requiring a retained prescription cannot be purchased with Cross-Border ePrescription.  

As a Finn you can purchase medicines with a Cross-border ePrescription in every pharmacy in Estonia and Croatia, and in some of the pharmacies in Portugal, Poland, Czech Republic and Spain. 

In Estonia, you can buy medicines with a Cross-Border ePrescription issued either in Finland, Latvia, Lithuania, Portugal, Croatia, Poland, Czechia and Spain. When you buy medicines with an electronic prescription, you must visit the pharmacy yourself. Bring a photo ID, such as a passport or ID card, to the pharmacy. Medicines classified as narcotic or psychotropic, anabolic steroids, medicines without marketing authorisation, extemporaneous medicines, or medical devices cannot be purchased with a Cross-Border ePrescription 

Estonians can purchase medicines with a cross-border e-prescription from all pharmacies in Finland, Latvia, Lithuania, Croatia, and Greece, as well as from selected pharmacies in Portugal, Poland, the Czech Republic, and Spain. 

About the study 

An online survey was conducted in spring 2021 among 664 community pharmacies in Estonia and Finland. The pharmacies which had dispensed at least one Cross-border ePrescription in 2020 were invited in the study. A total of 238 pharmacists responded to the survey. The response rate was 61.5% in Finland and 38.5% in Estonia.

For more information 

Leena Saastamoinen, Research Manager, The Finnish Medicines Agency
Tel. 029 522 3659
The email address format is firstname.lastname@fimea.fi

Johanna Timonen, University Researcher, University of Eastern Finland 

Reelika Jõgi, Product owner, Estonian State Agency of Medicines 

Daisy Volmer, Associate Professor, University of Tartu