Analysis of drugs returned by inpatient services after unit dose distribution in a portuguese public hospital

Abstract

Unit-dose has been considered the most effective dispensing system in hospital pharmacy, however not all drugs are administered, are then returned to the pharmacy. The analysis of non-administered drugs might provide important data regarding pharmacotherapeutic follow-up, but also regarding pharmacy management decisions. The present study aims at depicting the drugs returned to the pharmacy following their previous unit-dose dispensing. Methods: During a period of 45 days, the unused returned drugs of five different inpatient clinical services were analyzed regarding the state of conservation, justification for return, inpatient clinical service provenance, and dosage regimen. Of a total of 65280 unit-dose dispensed drugs, 25.2% were returned (n=16431) and 74.9% of SOS (i.e. medications prescribed as needed) drugs (n=6583) were unused. Excluding SOS drugs, more than a half of the returned drugs (52.4%, n=4967), were probably returned due to unintended omission of administration, after excluding patients that were not physically on the unit and patients whose treatments were modified. The large majority of returned drugs (98.6%, n=16201) were suitable for reintroduction in the medication circuit. In order to accomplish the basic principles of unit-dose dispensing genesis, the returned drugs must be kept to a minimum. Therefore, the suspension of dispensing SOS drugs by unit-dose should be considered. Additionally, the careful analysis of returned drugs should be promoted, in order to avoid, as much as possible, the omission of administration.info:eu-repo/semantics/publishedVersio

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