Starting an automated dose dispensing service provided by community pharmacies in Finland

Background In an automated dose dispensing (ADD) service, medicines are packed in unit-dose bags according to administration times. When the service is initiated, the patient’s medication list is reconciled and the medication is reviewed on the basis of this list. Objective The aim of this national study was to investigate how the medication list was reconciled, what type of medication review was conducted, and what changes were made to the patient’s medications when the ADD service is initiated. Setting Primary care in Finland. Method All patients enrolled in the service during a 3-week period in autumn 2010 were included in the study. All community pharmacies (n = 267) purchasing unit-dose bags from Espoonlahti Pharmacy documented the actions taken in the ADD initiation process using a structured data collection sheet. Main outcome measure Information sources needed in medication reconciliation, the type of medication review conducted and changes made to patients’ medications. Results Documentation was completed for 147 out of 325 new ADD users resulting 45 % as a response rate. More than one source was needed for 63 % of the patients in medication reconciliation. The most common sources used were nursing staff (72 % of the patients) and an existing medication list (71 %). Some type of medication review, most commonly a prescription review, was conducted for the majority of the patients (96 %), usually in multi-professional collaboration. Treatment-related changes were made for 43 % of the patients and technical changes were made for 93 % of the patients. Conclusion The medication list was incomplete for more than half of the patients. Some type of medication review was conducted for most of the patients. Both treatment-related changes and technical changes were made on patients’ medications during the initiation process. The start-up process of the ADD service needs further development to ensure a standard procedure and optimum use of resources.