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The benefits of a unit dose system in oral antibiotics dispensing: Azorean hospital pharmacists tackling the socioeconomic problem of leftovers in Portugal

  • At: PPR SIG 2021 (2021)
  • Type: Digital
  • By: COSTA, Tiago Filipe Tavares (Unidade de Saúde da Ilha de São Miguel (USISM), Portugal)
  • Co-author(s): Tiago Costa a),b) | Ana Cristina Pimentel a) | Luisa Mota-Vieira c),d),e) | Ana Cristina Castanha a) a) Pharmaceutical Services, Hospital do Divino Espírito Santo de Ponta Delgada, EPER, Ponta Delgada, Azores, Portugal b) Procurement Department and Pharmaceutical Services, Unidade de Saúde da Ilha de São Miguel, Ponta Delgada, Azores, Portugal c) Molecular Genetics and Pathology Unit, Hospital do Divino Espírito Santo de Ponta Delgada, EPER, Ponta Delgada, Azores, Portugal d)BioISI – Biosystems & Integrative Sciences Institute, Faculty of Sciences, University of Lisbon, Portugal eInstituto Gulbenkian de Ciência, Oeiras, Portugal
  • Abstract:


    In Portugal, oral antibiotics are usually dispensed in a predefined package size at the local community pharmacy. This rigid system allows the creation of inefficiencies (e.g. leftovers), since prescription regimens are flexible and sometimes the package does not correspond exactly to the prescribed treatment. To provide a solution to this problem, the Hospital do Divino Espírito Santo de Ponta Delgada (HDES) opened a Public Sales Unit (PSU) with a unit dose dispensing system of pharmaceuticals for its patients.


    To characterize and evaluate the unit dose system in oral antibiotics dispensing at the HDES-PSU, and to extrapolate the results at the Portuguese nationwide level.


    Oral antibiotics dispensing dynamics at the HDES-PSU were examined during a period of one year. Dispensed prescriptions were analyzed, and relevant information was collected and entered into a digital database for analysis. To extrapolate results at a nationwide level, a database from Statistics Portugal was used.


    The results revealed that the 663 registered interventions provided overall savings of 3939 pharmaceutical units, corresponding to 1032.99 €. The penicillins and beta-lactamase inhibitor combinations was the pharmacotherapeutic category which registered the highest amount of monetary savings (279.98 €) and savings in pharmaceutical units (1013). The Portuguese nationwide extrapolation indicated that a total of 276,833 pharmaceutical interventions could be registered, corresponding to 1,544.317 pharmaceutical units saved and to 434,085.85 €.


    The present study provides insights of how a unit dose dispensing system can contribute to solve the socioeconomic problems raised by leftovers of oral antibiotic dispensing practices occurring in healthcare systems, like the Portuguese one. Oral antibiotic package sizes must be reanalyzed by the pharmaceutical industry in order to comply with common prescription habits of physicians and governments should implement specific rules and legislations for the antibiotic dispensing circuit in pharmacies and hospitals.

Last update 4 October 2019

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