• Kristina Johnell and Johan Fastbom.
• Aging Research Center, Karolinska Institutet, Stockholm, Sweden. Kristina.Johnell@ki.se
• Scand J Prim Health Care. 2008 Jan 1; 26 (2): 86-91.

ObjectiveTo investigate whether the use of multi-dose drug dispensing is associated with potentially inappropriate drug use (IDU).DesignCross-sectional nationwide register-based study.SettingSweden.SubjectsPeople aged >or=75 years registered in the Swedish Prescribed Drug Register during October-December 2005.Main Outcome MeasuresPotentially 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).ResultsAfter 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.ConclusionOur 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.

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