Prevalence and Costs of Potentially Inappropriate Medications for Elderly People Using Automated Multidose Dispensing Service: A Nationwide Register-Based Study

OBJECTIVES: Automated dose dispensing (ADD) is a service to ensure the safe use of medicines, especially in older primary care patients using multiple drugs. Polypharmacy can increase the risk of using potentially inappropriate medications (PIMs), in which the potential harms may outweigh the clinical benefits for elders. This study aims to evaluate prevalence and costs of PIMs use in elderly people using ADD-service.

METHODS: The study population includes all individuals aged ≥75 years with at least one recorded dose distributed dispense in 2022. Data on medicine costs and PIMs dispensations in ADD were extracted from National Prescription Centre of Finland. The control group comprised all people of the same age with no ADD-service. PIMs use was defined by MED75+ -criteria. Costs of PIMs were calculated as total average annual cost per patient. Descriptive analyses were conducted using RStudio.

RESULTS: Study population included 94 216 ADD-service users. The prevalence of PIMs use was 38% in ADD patients and 33% in control group. The most frequently used PIMs were risperidone (14%) and quetiapine (12%) in ADD patients. The average annual cost of PIMs was €103 for ADD patients and €73 for control group.

CONCLUSIONS: Our study revealed high prevalence of PIMs use among elderly using ADD-service. ADD patients also had higher average annual cost of PIMs compared to control group. Healthcare professionals should actively work on identifying PIMs among ADD patients in order to decrease the use of high-risk medications and improve medication safety.