Polypharmacy and unit dose dispensing system (UDDS) in geriatric care

BACKGROUND: Multimorbid geriatric patients often require complex treatment. Effective management of polypharmacy has become one of the greatest challenges in patient care. Nevertheless, there is little information on how unit-dose dispensing systems (UDDS) can be adapted for the care of geriatric patients and well-integrated into the daily routine of clinical units. OBJECTIVE: We evaluated the acceptance rate and feasibility of unit-dose care of prescribed drugs, including perspectives of doctors and nurses in a geriatric clinic of a university hospital. MATERIAL AND METHODS: An entire ward staff (20 nurses, 11 doctors) was surveyed on 8 topics including safety of drug treatment and handling of blistered medication packages. We employed a mixed-method design using a questionnaire with a unipolar 5‑point Likert scale. RESULTS: The response rate to the survey was 74%. Most respondents (82%) agreed that unit dose delivery increases the safety of drug treatment and 77% agreed that unit dose supply reduces administration errors. The approval rate was 100% from doctors and 55% from nurses. However, most respondents (95%) did not consider dispensing of blister-packed medicines to geriatric patients to be appropriate, owing to impaired fine motor skills, cognitive deficits, dementia and delirium. CONCLUSION: This study found a high level of acceptance (87% of doctors and nursing staff) of unit dose dispensing systems for geriatric patients; however, unit-dose care was not considered to be universally applicable to all hospitalized patients. Successful implementation of UDDS for geriatric patients in particular needs a thorough evaluation and some modifications prior to implementation.