[Prescription of split doses in a nursing home: Contribution of an automated dose-dispensing machine]

Abstract

Objectives: The territorial pharmacy of the West of Paris carries out an automated dose dispensing for a nursing home. The machine overpacks dry oral forms in unit doses and dispenses them in named pillboxes. Tablets prescribed in fractions are currently dispensed in whole unit doses, fractioned in advance by a nurse, then administered by a caregiver. These operations present a number of risks, including a break in dose identification right through to administration. The objective was therefore to extend the automated dose dispensing to split tablets by repackaging.

Methods: The development of this new process, its software qualification and its evaluation after six months of routine use are described.

Results: This process is composed of three steps, secured by pharmaceutical controls: manual production of fractions in the preparatory area, automated repackaging using a barrel and automated dispensing in pillboxes. In total, 2000 fractions were produced in six months with a non-compliance rate lower than 5% and a negligible financial loss. Following the assumption of this activity by the pharmacy, the care team declares themselves satisfied by the gain in time and safety.

Conclusions: Automated dispensing of unit doses in fractions ensures identification of the dose from prescription to administration, thus limiting administration errors.

Keywords: Automated dose dispensing; Doses fractionnées; Formes orales sèches; Geriatrics care; Gériatrie ;Préparation des doses à administrer automatisée; Reconditionnement; Repackaging; Split-doses; dry oral forms.