Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2017 Sep 19;12(9):e0184420.
doi: 10.1371/journal.pone.0184420. eCollection 2017.

The expected and unexpected benefits of dispensing the exact number of pills

Carole Treibich  1 , Sabine Lescher  2 , Luis Sagaon-Teyssier  2   3 , Bruno Ventelou  1   3
Affiliations
Randomized Controlled Trial

The expected and unexpected benefits of dispensing the exact number of pills

Carole Treibich et al. PLoS One. .

Abstract

Background: From November 2014 to November 2015, an experiment in French community pharmacies replaced traditional pre-packed boxes by per-unit dispensing of pills in the exact numbers prescribed, for 14 antibiotics.

Methods: A cluster randomised control trial was carried out in 100 pharmacies. 75 pharmacies counted out the medication by units (experimental group), the other 25 providing the treatment in the existing pharmaceutical company boxes (control group). Data on patients under the two arms were compared to assess the environmental, economic and health effects of this change in drug dispensing. 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. 80% of eligible patients approved of the per-unit dispensing of their treatment. 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-no differences between groups. Finally, per-unit dispensing appeared to improve adherence to antibiotic treatment (marginal effect 0.21, IC 95, 0.14-0.28).

Conclusions: Supplying antibiotics per unit is not only beneficial in terms of a reduced number of pills to reimburse or for the environment (less pills wasted and non-recycled), but also has a positive and unexpected impact on adherence to treatment, and thus on both individual and public health.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: I have read the journal's policy and the authors have declared the following competing interests: Data collection was funded by the French Ministry of Health (Direction Générale de la Santé, French Ministry of Health). However we have the full-property of the data and the Health Ministry has no rights on the content of the analysis and the publications which could result from the use of the data. BV also benefited from the support of the “Drug-Safe” program from the French National Agency for Medicines and Health Products Safety (Agence Nationale de Sécurité du Médicament). Our professional statute warrants a total independency. We declare that we have no other conflict of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

References

    1. Grigoryan L, Burgerhof JG, Degener JE, Deschepper R, Stalsby Lundborg C, Monnet DL, et al. Determinants of self-medication with antibiotics in Europe: the impact of beliefs, country wealth and healthcare system. Journal of Antimicrobial Chemotherapy. 2008; 61:1172–1179. doi: 10.1093/jac/dkn054 - DOI - PubMed
    1. Mayor S. Antibiotic resistance is highest in south and east Europe. BMJ. 2005; 330:383.
    1. European Centre for Disease Prevention and Control. Antimicrobial resistance surveillance in Europe 2014. Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS-Net). Stockholm: ECDC; 2015
    1. Goosens H, Ferech M, Stichele RV, Elseviers M. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet. 2005; 365: 579–587. doi: 10.1016/S0140-6736(05)17907-0 - DOI - PubMed
    1. Agence Nationale de Sécurité du Médicament et des produits de santé (ANSM). L’évolution des consommations d’antibiotiques en France entre 2000 et 2013. 2014. ANSM.

Publication types

LinkOut - more resources