Excessive Polypharmacy and Potentially Inappropriate Medications Are Common in Automated Dose Dispensing
Abstract
Objectives
Automated dose dispensing (ADD) is a service that ensures safe pharmacotherapy for persons using concomitant multiple medications. When starting the ADD service, the medication list of the user should be reviewed by healthcare professionals. However, potentially inappropriate medications (PIMs)
for elderly people are still commonly dispensed in ADD. The aim of this register-based study is to describe the users of the ADD service and their medications dispensed through ADD. Furthermore, we examine PIMs use among ADD-users and non-ADD-users.
Material and Methods
The study population consisted of all persons with at least one recorded dose-dispensing in the centralized national Prescription Centre in 2022. Product- and patient-level data were collected for each dispensation. We also examined people of the same age with no ADD service. PIM use was defined using Meds75+ criteria. Descriptive analyses were conducted using R software.
Results
Altogether, 120,021 persons used an ADD service in 2022. Their mean age was 81 years (range 6–over 100 years) and 63% of them were women. Excessive polypharmacy (at least 10 medications in use) was observed in 73% of ADD users. A total of 353 different active pharmaceutical ingredients and their combinations, most commonly bisoprolol, paracetamol furosemide, calcium combinations and pantoprazole were dose-dispensed. Of 75-year-old ADD patients, 38% used PIMs and 33% of non-ADD-users.
Conclusion
ADD users are typically elderly individuals with excessive polypharmacy. Medications in ADD primarily consist of medicines to treat public health diseases, but PIMs were also dispensed. According to our results, healthcare professionals should pay more attention to reviewing the overall medication of ADD users, especially the use of psychotropic drugs, to improve medication safety for ADD users.
Full text (in Finnish) (dosis.fi)
Authors
Satu Kuusisto, Hanna Koskinen, Fredriikka Nurminen, Heini Kari
Additional Information
- Peer-Reviewed: yes.
- Open Access: yes.
- Cite as: Kuusisto, S., Koskinen, H., Nurminen, F., & Kari, H. (2025). Merkittävä monilääkitys ja iäkkäillä vältettävät lääkkeet yleisiä lääkkeiden annosjakelussa. Dosis, 41(2), 162–175.
