Background In France, drug retrocession consists of delivering to outpatients innovative drugs reserved for hospitals due to their required monitoring. Such patients are at the interface of primary care through community practitioners (physicians, pharmacists or medical biologists) and secondary care through hospital pharmacists for the delivery of the retroceded drugs. In addition, there are few networks connecting the community and hospital healthcare professionals (HCPs). This explains the frequent dysfunctions and poor therapeutic management of this drug supply chain, thereby resulting in critical patient safety issues.

Purpose This project aimed to study the incidents in this drug supply chain in our health territory and to propose solutions, allowing safety and continuity of care for our patients.

Material and methods Adverse events were collected over 2 years in 2 hospitals and were classified into different ‘never events’.

Results 6 never events were defined:

1. Drug interaction between community and hospital medications.

2. No information to outpatients about requirements of hospital pharmacy dispensation.

3. Cessation of treatment.

4. No compliance with prescription or dispensation constraints.

5. No therapeutic management.

6. No compliance with confidentiality requirements.

The main source of all of these dysfunctions in the drug supply chain was the lack of coordination between the different HCPs.

Conclusion This study has shown that solutions to secure this medication system cannot be provided by one hospital alone. Outpatient mobility needs regional management with cooperation between the 9 public hospitals, community pharmacies and physicians to ensure continuous and safe care. As of next year, hospitals and community pharmacies will be connected through the pharmaceutical file, a secured cloud service managed by the French pharmacy college, to share information on drug dispensations and interactions. Common tools such as patient information leaflets will be created to optimise pharmaceutical care. All potential dysfunctions in these new network practices for drug retrocession will be collected by the quality department of one participating hospital for feedback and optimisation. This project is supported by our regional health institution (OMEDIT) and the French national college of pharmacists, and shows the mobilisation of the healthcare professionals in Normandy to improve patient care.

References and/or acknowledgements Thibault Simon, Frédérique Leroy, Carole Richer, Claire Leluan, Sophie Cote, Christophe Delplanque.

No conflict of interest