Analysis of impact of unit dose drug distribution system on pharmacotherapy optimization
More details
Hide details
Zakład Farmakoekonomiki Katedry Nauk Społecznych Wydziału Farmaceutycznego z Oddziałem Medycyny Laboratoryjnej, Śląski Uniwersytet Medyczny w Katowicach
Anna Żuk   

Zakład Farmakoekonomiki Katedry Nauk Społecznych Wydziału Farmaceutycznego z Oddziałem Medycyny Laboratoryjnej, Śląski Uniwersytet Medyczny w Katowicach, ul. Ostrogórska 30, 41-200 Sosnowiec, tel. 32 364 13 70
Ann. Acad. Med. Siles. 2016;70:143–153
A unit dose system enables the delivery of drugs from the hospital pharmacy to the hospital unit for a particular patient. Each dose is separately packaged and labeled with general information about the drug and the pa¬tient for whom it is designated. There is no need for prior drug transference, calculation, or handling by nurses. The drugs are stored in hospital units for the next 24 hours of treatment of each patient and are used in emergencies.

Material and method:
The aim of the study was to analyze the impact of a unit dose distribution system on opti¬mizing drug treatment. For this purpose, systematic literature review was performed. The methodology part was mod¬elled based on the article by Sinnemaki et al. [1]. 15 studies, which were conducted between 1997 and 2011, were included in the research (studies ranged from 1 month to 5 years). The studies regard the errors occurring during drug distribution, drug preparation time, accuracy of dispensing medications and the stability of drugs repacked into unit doses.

The study results indicated that medical errors were minimized when a unit dose system was used and an optimal time of drug preparation in a unit dose system was achieved. The pharmacy technicians and pharmacists were accurate in terms of preparing the unit doses. Furthermore, the drugs repacked into a unit dose are stable.

It was noted that there is a need for further research to measure the impact of the unit dose system on optimizing drug treatment.

Sinnemäki J., Sihvo S., Isojärvi J., Blom M., Airaksinen M., Mäntylä A. Automated dose dispensing service for primary healthcare patients: a systematic review. Syst. Rev. 2013; 2: 1.
Anacleto T.A., Perini E., Rosa M.B., César C.C. Medication errors and drug-dispensing systems in a hospital pharmacy. Clinics 2005; 60(4): 325–332.
Bohand X., Simon L., Perrier E., Mullot H., Lefeuvre L., Plotton C. Frequency, types, and potential clinical significance of medication-dispensing errors. Clinics 2009; 64(1): 11–16.
Franklin B.D., O'Grady K., Donyai P., Jacklin A., Barber N. The impact of a closed-loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: a before-and-after study. Qual. Saf. Health Care 2007; 16(4): 279–284.
Barker K.N., Pearson R.E., Hepler C.D., Smith W.E., Pappas K.N. Effect of an automated bedside dispensing machine on medication errors. Am. J. Hosp. Pharm. 1984; 41(7): 1352–1358.
Grześkowiak E. Farmacja szpitalna, pdf_file/0020/7715/78_farmacja_szpitalna_13072011.pdf. [data dostępu: listopad 2013].
Fedorowicz O., Kempczyńska M. Funkcjonalne rozwiązania w or-ganizacji nowoczesnej apteki szpitalnej. Farm. Pol. 2009; 65(11): 821–825.
Novek J., Rudnick W. Automatic drug dispensing help or hindrance? Can Nurse 2000; 96(4): 29–33.
Fontan J.E., Maneglier V., Nguyen V.X., Loirat C., Brion F. Medication errors in hospitals: computerized unit dose drug dispensing system versus ward stock distribution system. Pharm. World Sci. 2003; 25(3): 112–117.
Sosnowiec: uruchomili aptekę z systemem zarządzania dawką leku. [data dostępu: listopad 2014].
Grzelak-Hodor J. Unit dose pomoże szpitalom obniżyć wydatki na leki. Puls Farmacji 2008; 12(17). Data publikacji 25.06.2008.
Grzelak-Hodor J. Unit Dose: indywidualne porcje leków. http:// //,17785,.... [data dostępu: listopad 2014].
Taxis K., Dean B., Barber N. Hospital drug distribution systems in the UK and Germany – a study of medication errors. Pharm. World Sci. 1999; 21(1): 25–31.
Al Adham M., Abu Hamad B. Drug dispensing systems in Gaza hospitals: a comparative study. East Mediterr Health J. 2011; 17(10): 722–729.
Bohand X., Aupée O., Le Garlantezec P., Mullot H., Lefeuvre L., Simon L. Medication dispensing errors in a French military hospital pharmacy. Pharm. World Sci. 2009; 31(4): 432–438.
Max B.E., Itokazu G., Danziger L.H., Weinstein R.A. Assessing unit dose system discrepancies. Am. J. Health Syst. Pharm. 2002; 59(9): 856–858.
Mirco A., Campos L., Falcão F., Nunes J.S., Aleixo A. Medication errors in an internal medicine department. Evaluation of a computerized prescription system. Pharm. World Sci. 2005; 27(4): 351–352.
Vélez-Díaz-Pallarés M., Delgado-Silveira E., Carretero-Accame M.E., Bermejo-Vicedo T. Using Healthcare Failure Mode and Effect Analysis to reduce medication errors in the process of drug prescription, validation and dispensing in hospitalised patients. BMJ Qual Saf. 2013; 22(1): 42–52.
Reed M., Thomley S., Ludwig B., Rough S. Experience with a “tech-check-tech” program in an academic medical center. Am. J. Health Syst. Pharm. 2011; 68(19): 1820–1823.
Ambrose P.J., Saya F.G., Lovett L.T., Tan S., Adams D.W., Shane R. Evaluating the accuracy of technicians and pharmacists in checking unit dose medication cassettes. Am. J. Health Syst. Pharm. 2002; 59(12): 1183–1188.
Bennett J., Harper-Femson L.A., Tone J., Rajmohamed Y. Improving medication administration systems: an evaluation study. Can Nurse. 2006; 102(8): 35–39.
Pelayo S., Hassler S., Bernonville S., Aldegheri J., Beuscart-Zephir M.C. Safety-oriented usability test of a semi-automated unit dose system: role of task allocation between human and machine. Stud. Health Technol. Inform. 2013; 194: 103–109.
Yamazaki N., Taya K., Shimokawa K., Ishii F. The most appropriate storage method in unit-dose package and correlation between color change and decomposition rate of aspirin tablets. Int. J. Pharm. 2010; 396(1–2): 105–110.
Gupta A., Ciavarella A.B., Rothman B., Faustino P.J., Khan M.A. Stability of gabapentin 300-mg capsules repackaged in unit dose containers. Am. J. Health Syst. Pharm. 2009; 66(15): 1376–1380.
Shah R.B., Prasanna H.R., Rothman B., Khan M.A. Stability of ra-nitidine syrup re-packaged in unit-dose containers. Am. J. Health Syst. Pharm. 2008; 65(4): 325–329.
Kmieciak K., Biernikiewicz M. Wzrost jakości farmakoterapii ze szczgólnym uwzględnieniem błędów medycznych wraz z optymalizacją kosztów dzięki zastosowaniu systemów dose dispensing. Farmacja Szpitalna w Polsce i na świecie. 2007; 4(5): 7–10.
Hodor J. Zbyt dużo pomyłek przy przepisywaniu leków. [da-ta dostępu: listopad 2014].
Staszewski R., Paliwoda A. Lekoterapia. Menedżer Zdr. 2005; 5(5): 48–52.
Poley M.J., Bouwmans C.A., Hanff L.M., Roos P.J., van Ineveld B.M. Efficiency of different systems for medication distribution in an academic children's hospital in The Netherlands. Pharm. World Sci. 2004; 26(2): 83–89.
Eddlemon J.K., Hayman J.N., Breland B.D. Establishment and operation of an oncology satellite pharmacy. Am. J. Hosp. Pharm. 1984; 41(10): 2045–2048.
Chapuis C1., Roustit M., Bal G., Schwebel C., Pansu P., David-Tchouda S., Foroni L., Calop J., Timsit J.F., Allenet B., Bosson J.L., Bedouch P. Automated drug dispensing system reduces medication errors in an intensive care setting. Crit. Care Med. 2010; 38(12): 2275–2281.
Sjöberg C., Edward C., Fastbom J., Johnell K., Landahl S., Narbro K., Wallerstedt S.M. Association between multi-dose drug dispensing and quality of drug treatment--a register-based study. PLoS One 2011; 6(10): e26574.
Wakefield D.S., Ward M.M., Loes J.L., O'Brien J. A network collaboration implementing technology to improve medication dispensing and administration in critical access hospitals. J. Am. Med. Inform. Assoc. 2010; 17(5): 584–587.
Merks P., Szczęśniak K., Fedorowicz O., Olszewska A., Jakóbczyk P., Kozłowska-Wojciechowska M. Robotisation in pharmacy as a factor supporting the introduction of full pharmaceutical care. Farm. Pol. 2013; 69(7): 408–416.