Prescribing beyond borders: Navigating challenges and opportunities in cross-border ePrescriptions for enhanced medication access and safety.

Background: The European cross-border electronic prescription (CBeP) was first introduced in Estonia and Finland. The CBeP service is gradually being implemented across Europe, prompting a need for practical studies to assess its benefits and potential shortcomings.

Objective: This study aimed to investigate Estonian and Finnish pharmacists' experiences with patient identification, personal data protection and safe use of medications with CBeP, as well as main advantages and areas of development of CBeP.

Methods: An online survey was conducted among Estonian and Finnish pharmacists in Spring 2021. The survey was distributed to 664 community pharmacies (289 Estonian and 375 Finnish pharmacies) where CBePs had been dispensed in 2020. The data were analysed using frequencies and a chi-square test. Answers to open-ended questions were categorized using content analysis and quantifying.

Results: In total, 84 responses from Estonia and 154 responses from Finland were included in the study. Majority of the respondents had never or had rarely encountered problems with identifying the patient with CBeP. Nearly all respondents rated the CBeP system to be safe from the standpoint of personal data protection. Approximately 70 % of the respondents in both countries agreed that it is difficult to counsel the patient with CBeP due to language barrier. More than half of the respondents reported that it is not easy to monitor drug interactions with CBeP. The most often mentioned benefit of CBeP was an improved medication availability and the main problem the CBeP dispensing software rigidity.

Conclusions: Estonian and Finnish pharmacists recognize the positive impact of CBeP on medication availability. Variations in providing patient counselling due to language barriers highlight the need for improved communication tools. Addressing concerns about drug interaction monitoring and technical rigidity is essential for seamless cross-border adoption of CBeP in Europe.