title: Towards more reliable automated multi-dose dispensing: retrospective follow-up study on medication dose errors and product defects.
abstract: To date, little is known on applicability of different types of pharmaceutical dosage forms in an automated high-speed multi-dose dispensing process. The purpose of the present study was to identify and further investigate various process-induced and/or product-related limitations associated with multi-dose dispensing process. The rates of product defects and dose dispensing errors in automated multi-dose dispensing were retrospectively investigated during a 6-months follow-up period. The study was based on the analysis of process data of totally nine automated high-speed multi-dose dispensing systems. Special attention was paid to the dependence of multi-dose dispensing errors/product defects and pharmaceutical tablet properties (such as shape, dimensions, weight, scored lines, coatings, etc.) to profile the most suitable forms of tablets for automated dose dispensing systems. The relationship between the risk of errors in dose dispensing and tablet characteristics were visualized by creating a principal component analysis (PCA) model for the outcome of dispensed tablets. The two most common process-induced failures identified in the multi-dose dispensing are predisposal of tablet defects and unexpected product transitions in the medication cassette (dose dispensing error). The tablet defects are product-dependent failures, while the tablet transitions are dependent on automated multi-dose dispensing systems used. The occurrence of tablet defects is approximately twice as common as tablet transitions. Optimal tablet preparation for the high-speed multi-dose dispensing would be a round-shaped, relatively small/middle-sized, film-coated tablet without any scored line. Commercial tablet products can be profiled and classified based on their suitability to a high-speed multi-dose dispensing process.
authors.affiliation: Division of Pharmaceutical Technology, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland.
authors.forename: Iida
authors.initials: I
authors.lastname: Palttala
authors.forename: Jyrki
authors.initials: J
authors.lastname: Heinämäki
authors.forename: Outi
authors.initials: O
authors.lastname: Honkanen
authors.forename: Risto
authors.initials: R
authors.lastname: Suominen
authors.forename: Osmo
authors.initials: O
authors.lastname: Antikainen
authors.forename: Jouni
authors.initials: J
authors.lastname: Hirvonen
authors.forename: Jouko
authors.initials: J
authors.lastname: Yliruusi
mesh_terms: D004305:Dose-Response Relationship, Drug; D004348:Drug Labeling / Q000379:methods* / Q000592:standards; D004349:Drug Packaging; D011307:Drug Prescriptions / Q000592:standards*; D005500:Follow-Up Studies; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control*; D004364:Pharmaceutical Preparations / Q000592:standards*; D019338:Polypharmacy; D012189:Retrospective Studies
chemical_list: D004364:Pharmaceutical Preparations