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Dose dispensing promotes medication safety


According to a recent dissertation research, automated dose dispensing decreases medicine consumption among elderly and usage of inappropriate medications for seniors. Integrating medication review in dose-dispensing service helps to eliminate unnecessary medicines.

Medicine usage typically increases with age, and many seniors have several different medicines simultaneously in use. For example, in a survey* commissioned by Oriola, 36% of respondents aged 70 to 89 years had used more than four different prescription medicine during the last year. Simultaneous use of several medicines can affect the quality of medical treatment.

Typical challenges in pharmacotherapy of elderly are, for example, medicine interactions and excessive or unnecessary use of psychotropic or sedative medicines. The risks of pharmacotherapy can be mitigated with various measures, such as maintaining up-to-date medication lists and medication review. It is recommended that automated dose dispensing includes these measures,” says Juha Sinnemäki, whose doctoral dissertation regarding implementation and effectiveness of automated dose dispensing in Finland was examined in the University of Helsinki in October.

Medication changes were made for nearly half of the patients when initiating dose-dispensing service

In dose dispensing, a pharmacy delivers patients their medicines in ready-to-use single dose pouches, which are provided by Oriola’s automated dose-dispensing production, for example. When a patient takes the service in use, their medication list is reviewed in a pharmacy. The medication list should include all prescription and over-the-counter medicines that a person has in use. However, Sinnemäki’s research revealed that when initiating dose dispensing, medication list was incomplete for more than half of the patients, and pharmacists collected information on patient’s medication from multiple sources to reconcile the list.

Medication-related therapeutic changes were implemented for almost half of the patients when dose dispensing was initiated. The service also decreased medicine usage as well as individual use of inappropriate medications for elderly. This may result from eliminating unnecessary medicines after medication review, but also from decreasing medical waste as patients get only the necessary medicines for two weeks at a time. The results seem to indicate that safety of pharmacotherapy could be improved in healthcare by wider use of dose dispensing. However, the service should always include adequate medication review,” Sinnemäki says.

Oriola reviews medication of thousands of dose-dispensing patients annually

Oriola’s dose-dispensing service includes both in Finland and in Sweden a medication review that is provided as a service for pharmacies. Medication is reviewed when a patient takes dose dispensing in use as well as when medicine dosage changes or a new medicine is added. Any discovered issues are consulted with a patient’s physician, who decides potential changes to medication.

Ensuring pharmaceutical quality in dose dispensing is an integral part of patient safety. In Finland, we send out annually approximately 5,000 inquiries related to unclarities in patient’s medication to the pharmacies who use our dose-dispensing service and through them to patients’ physician or care unit. Approximately 70% of the inquiries lead to changes in medication before initiating dose dispensing,” says Eero Lamminen, Director of Business Unit Services at Oriola.

Juha Sinnemäki’s dissertation research is available here.

*The survey was conducted in December 2019, and it had 900 respondents aged 70 to 89 years.