Personal automated dose-dispensing – implementation in Estonia

Jürgen Jänese, pharmacy student, Department of Pharmacy, Faculty of Medicine, University of Tartu, EstoniaJyrki Heinämäki, professor, Department of Pharmacy, Faculty of Medicine, University of Tartu, Estonia

Daisy Volmer, senior lecturer, Department of Pharmacy, Faculty of Medicine, University of Tartu, Estonia

Personal automated dose-dispensing (PADD) of medicines aims to in-crease medication adherence, cost-containment and the quality of drug delivery. Many studies at the international level have shown that PADD provides advantages to the quality of service including patients and pharmacies. In Estonia PADD was introduced for nursing homes as a pilot project in July 2012 and for primary care patients in August 2013.

To assess the demand for PADD, its potential target groups and com-pensation methods in Estonia.

This qualitative focus group study assessed different prospects concern-ing the PADD-related project in Estonia. The stakeholders of Estoni-an healthcare system (Figure 1) responded to the questionnaire about awareness of PADD, potential target groups, reimbursement issues and possible implementation of PADD in different institutions level.

Of the respondents (n=17) 94% demonstrated a good knowledge about the PADD concept and supported the idea of providing PADD for nursing and elderly home patients (Figure 2). Total 71% of the re-spondents agreed that the service could be aimed to outpatients and 47% for inpatients.

The awareness of representatives of different authorities, institutions and organisations of the service for personal automated dose-dispens-ing of medicines was high and the following views and ideas were pre-sented:• there is a clear need for implementation of PADD in Estonia,• nursing/elderly homes and patients with memory and cognitive

disorders using polypharmacotherapy could be the potential tar-get group of the service,

• the service could be compensated by the Estonian Health Insur-ance Fund,

• the service needs to be introduced to patients by pharmacists, GPs and family nurses.

Further negotiations and efforts are needed to achieve consensus about the future implementation of PADD in Estonia.

This research was supported by the European Social Fund’s Doctoral Studies and Internationalisation Programme DoRa.

Figure 1. Participants of the focus group study.

Figure 2. Potential PADD target groups in Estonia – opinions of focus group study participants (%).

Figure 3. Potential compensation provider for PADD in Estonia - opin-ions of focus group study participants (%).

Figure 4. Specialists/institutions introducing PADD service to the pub-lic in Estonia - opinions of focus group study participants (%).

Total 82% of the participants considered the Estonian Health Insur-ance Fund (EHIF) as the primary compensation provider for PADD services (Figure 3). However, the compensation rate of PADD covered by EHIF is a topic of future negotiations and the need-based approach to PADD should be discussed.

PADD represents a form of pharmaceutical care service, ensuring a close personal contact between a pharmacist, general practitioner (GP) or family nurse and the patient (or his/her representative) and the ser-vice should be introduced to patients by named healthcare specialists (Figure 4). Apart of pharmacists, GPs and nurses, social care and wel-fare specialists should be involved in the introduction of the PADD service as well.

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