Multi-dose drug dispensing and inappropriate drug use: A nationwide register-based study of over 700,000 elderly

Scand J Prim Health Care. 2008;26(2):86-91. doi: 10.1080/02813430802022196.


Objective: To investigate whether the use of multi-dose drug dispensing is associated with potentially inappropriate drug use (IDU).

Design: Cross-sectional nationwide register-based study.

Setting: Sweden.

Subjects: People aged >or=75 years registered in the Swedish Prescribed Drug Register during October-December 2005.

Main outcome measures: Potentially IDU, i.e. anticholinergic drugs, long-acting benzodiazepines, concurrent use of three or more psychotropic drugs, and combinations of drugs that may lead to potentially serious drug-drug interactions (DDIs).

Results: After adjustment for age and number of dispensed drugs, any IDU, anticholinergic drugs, and three or more psychotropic drugs were associated with multi-dose drug dispensing, whereas the opposite relationship prevailed for long-acting benzodiazepines among women and potentially serious DDIs in both men and women. Among the subjects aged 75-79 years, multi-dose drug dispensing was even more strongly associated with any IDU, anticholinergic drugs, three or more psychotropic drugs in both men and women, and long-acting benzodiazepines among men.

Conclusion: Our results indicate that multi-dose users may be more exposed to potential IDU. However, multi-dose users seem to have a lower probability of potentially serious DDIs. Future research on multi-dose drug dispensing is necessary to ensure a high quality of drug therapy within this system.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Cross-Sectional Studies
  • Drug Interactions
  • Drug Packaging
  • Drug Prescriptions*
  • Drug Utilization Review*
  • Drug-Related Side Effects and Adverse Reactions
  • Female
  • Humans
  • Male
  • Medication Errors / prevention & control
  • Pharmaceutical Preparations / administration & dosage*
  • Polypharmacy
  • Practice Patterns, Physicians'
  • Risk Factors
  • Sweden


  • Pharmaceutical Preparations