Abstract
Background: From August 2016 to August 2017, an experiment in Gwalior local private and government #pharmacies replaced traditional
pre-packed boxes by per-unit #dispensing of #pills in the exact numbers prescribed, for 14 #antibiotics.
Methods: A cluster randomized control trial was carried out in
10 pharmacies. 5 pharmacies counted out the medication by units
(experimental group), the other 5 providing the treatment in the
existing Pharmaceutical company boxes (control group). Data on patients
under the two arms were compared to assess the #epidemiological, economic
and #healtheffects of this change in #drugdispensing. In particular,
Adherence was measured indirectly by comparing the number of pills left
at the end of the prescribed treatment.
Results: Out of the 1185 patients included during 3 sessions
of 4 consecutive weeks each, 907 #patients experimented the personalized
delivery and 278 were assigned to the control group, consistent with a
1/3 randomization-rate at the pharmacy level. Patient consent was taken
before assigning in each group. The initial packaging of the drugs did
not match with the prescription in 60% of cases and per-unit dispensing
reduced by 10% the number of pills supplied. 13.1% of patients declared
that they threw away pills residuals instead of recycling Finally,
perunit
dispensing appeared to improve adherence to antibiotic treatment
(marginal effect 0.21, IC 95, 0.14–0.28).
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