Polypharmacy and unit dose dispensing system (UDDS) in geriatric care : Challenges from the perspective of healthcare staff

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.

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.

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.

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.

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.