Impact of the automated dose dispensing with medication review on geriatric primary care patients drug use in Finland: a nationwide cohort study with matched controls

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Objective: In an automated dose dispensing (ADD) service, medicines are dispensed in unit-dose bags according to administration times. When the service is initiated, the patient’s medication list is reconciled and a prescription review is conducted. The service is expected to reduce drug use. The aim of this national controlled study was to investigate whether the ADD service with medication review reduces drug use among geriatric primary care patients. Design, setting and patients: This is a nationwide cohort study with matched controls. The study group consisted of all primary care patients ≥65 years enrolled in the ADD service in Finland during 2007 (n = 2073). Control patients (n = 2073) were matched by gender, age, area of patient’s residence and number of the prescription drugs reimbursed. The data on all prescription drugs reimbursed during the 1 year periods before and after the ADD service enrollment were extracted from the Finnish National Prescription Register. Drug use was calculated as defined daily doses (DDD) per day. Results: The studied 20 most used drugs covered 86% of all reimbursed drug use (in DDD) of the study group. The use of 11 out of these 20 active substances studied was reduced significantly (p < .001–.041) when the drug use was adjusted by the number of chronic diseases. Two of these drugs were hypnotics and six were cardiovascular system drugs. Conclusions: Drug use was decreased after initiation of the ADD service in primary care patients ≥65 years compared to matched controls in this 1 year cohort study. Further studies should be conducted in order to explore the causality, assess the ADD service’s impact on drug use quality and costs, as well as impact of accompanied prescription review on positive outcomes.
Originalspråkengelska
TidskriftScandinavian Journal of Primary Health Care
Volym35
Utgåva4
Sidor (från-till)379-386
Antal sidor8
ISSN0281-3432
DOI
StatusPublicerad - 2017
MoE-publikationstypA2 Granska artikel i en vetenskaplig tidskrift

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@article{30fc97152fe645a49b3d04c0b797ec83,
title = "Impact of the automated dose dispensing with medication review on geriatric primary care patients drug use in Finland: a nationwide cohort study with matched controls",
abstract = "Objective: In an automated dose dispensing (ADD) service, medicines are dispensed in unit-dose bags according to administration times. When the service is initiated, the patient’s medication list is reconciled and a prescription review is conducted. The service is expected to reduce drug use. The aim of this national controlled study was to investigate whether the ADD service with medication review reduces drug use among geriatric primary care patients. Design, setting and patients: This is a nationwide cohort study with matched controls. The study group consisted of all primary care patients ≥65 years enrolled in the ADD service in Finland during 2007 (n = 2073). Control patients (n = 2073) were matched by gender, age, area of patient’s residence and number of the prescription drugs reimbursed. The data on all prescription drugs reimbursed during the 1 year periods before and after the ADD service enrollment were extracted from the Finnish National Prescription Register. Drug use was calculated as defined daily doses (DDD) per day. Results: The studied 20 most used drugs covered 86{\%} of all reimbursed drug use (in DDD) of the study group. The use of 11 out of these 20 active substances studied was reduced significantly (p < .001–.041) when the drug use was adjusted by the number of chronic diseases. Two of these drugs were hypnotics and six were cardiovascular system drugs. Conclusions: Drug use was decreased after initiation of the ADD service in primary care patients ≥65 years compared to matched controls in this 1 year cohort study. Further studies should be conducted in order to explore the causality, assess the ADD service’s impact on drug use quality and costs, as well as impact of accompanied prescription review on positive outcomes.",
keywords = "Automated dose dispensing, medication safety, drug use, prescription review, geriatric patients, PEOPLE, 317 Pharmacy",
author = "Juha Sinnem{\"a}ki and Marja Airaksinen and Maria Valaste and Saastamoinen, {Leena K.}",
year = "2017",
doi = "10.1080/02813432.2017.1398933",
language = "English",
volume = "35",
pages = "379--386",
journal = "Scandinavian Journal of Primary Health Care",
issn = "0281-3432",
publisher = "Taylor & Francis",
number = "4",

}

TY - JOUR

T1 - Impact of the automated dose dispensing with medication review on geriatric primary care patients drug use in Finland

T2 - a nationwide cohort study with matched controls

AU - Sinnemäki, Juha

AU - Airaksinen, Marja

AU - Valaste, Maria

AU - Saastamoinen, Leena K.

PY - 2017

Y1 - 2017

N2 - Objective: In an automated dose dispensing (ADD) service, medicines are dispensed in unit-dose bags according to administration times. When the service is initiated, the patient’s medication list is reconciled and a prescription review is conducted. The service is expected to reduce drug use. The aim of this national controlled study was to investigate whether the ADD service with medication review reduces drug use among geriatric primary care patients. Design, setting and patients: This is a nationwide cohort study with matched controls. The study group consisted of all primary care patients ≥65 years enrolled in the ADD service in Finland during 2007 (n = 2073). Control patients (n = 2073) were matched by gender, age, area of patient’s residence and number of the prescription drugs reimbursed. The data on all prescription drugs reimbursed during the 1 year periods before and after the ADD service enrollment were extracted from the Finnish National Prescription Register. Drug use was calculated as defined daily doses (DDD) per day. Results: The studied 20 most used drugs covered 86% of all reimbursed drug use (in DDD) of the study group. The use of 11 out of these 20 active substances studied was reduced significantly (p < .001–.041) when the drug use was adjusted by the number of chronic diseases. Two of these drugs were hypnotics and six were cardiovascular system drugs. Conclusions: Drug use was decreased after initiation of the ADD service in primary care patients ≥65 years compared to matched controls in this 1 year cohort study. Further studies should be conducted in order to explore the causality, assess the ADD service’s impact on drug use quality and costs, as well as impact of accompanied prescription review on positive outcomes.

AB - Objective: In an automated dose dispensing (ADD) service, medicines are dispensed in unit-dose bags according to administration times. When the service is initiated, the patient’s medication list is reconciled and a prescription review is conducted. The service is expected to reduce drug use. The aim of this national controlled study was to investigate whether the ADD service with medication review reduces drug use among geriatric primary care patients. Design, setting and patients: This is a nationwide cohort study with matched controls. The study group consisted of all primary care patients ≥65 years enrolled in the ADD service in Finland during 2007 (n = 2073). Control patients (n = 2073) were matched by gender, age, area of patient’s residence and number of the prescription drugs reimbursed. The data on all prescription drugs reimbursed during the 1 year periods before and after the ADD service enrollment were extracted from the Finnish National Prescription Register. Drug use was calculated as defined daily doses (DDD) per day. Results: The studied 20 most used drugs covered 86% of all reimbursed drug use (in DDD) of the study group. The use of 11 out of these 20 active substances studied was reduced significantly (p < .001–.041) when the drug use was adjusted by the number of chronic diseases. Two of these drugs were hypnotics and six were cardiovascular system drugs. Conclusions: Drug use was decreased after initiation of the ADD service in primary care patients ≥65 years compared to matched controls in this 1 year cohort study. Further studies should be conducted in order to explore the causality, assess the ADD service’s impact on drug use quality and costs, as well as impact of accompanied prescription review on positive outcomes.

KW - Automated dose dispensing

KW - medication safety

KW - drug use

KW - prescription review

KW - geriatric patients

KW - PEOPLE

KW - 317 Pharmacy

U2 - 10.1080/02813432.2017.1398933

DO - 10.1080/02813432.2017.1398933

M3 - Review Article

VL - 35

SP - 379

EP - 386

JO - Scandinavian Journal of Primary Health Care

JF - Scandinavian Journal of Primary Health Care

SN - 0281-3432

IS - 4

ER -