Multidose Drug Dispensing in Primary Care: A Review of the Literature

Abstract

Multidose drug dispensing (MDD) is an adherence aid that provides patients with machine-dispensed medicines in disposable unit bags, usually for a 14-day period. The system has been implemented in primary care in some European countries. This review aims to summarize the current evidence on the MDD system’s effect on patient safety in home-dwelling patients. We found 60 peer-reviewed articles from five different countries. The studies indicate that MDD has both positive and negative effects on patient safety, and can affect all steps in the medication-use process: prescribing, dispensing, administration and monitoring. Specifically, MDD can increase medication adherence and reduce discrepancies in medication records for patients in primary care. However, it also seems to result in more inappropriate prescribing and more medication errors during discharge from hospitals. In order to improve the MDD system, it is necessary to involve all actors in the medication-use process and define their responsibilities. Specifically, we see that there is a need for better systems to identify patients during care transitions, and increased involvement of the patients themselves.