Patients’ inability to follow the instructions of a prescribed medication is one of the key factors that has put patient safety and the efficiency of healthcare systems across the EU in serious danger.

Leading scientific experts and representatives of the healthcare sector gathered in Brussels to discuss the issue and to shed light on the fact that dose dispensing – when the tablets or capsules that are used regularly by a patient are packaged into doses either by machine or by hand – is a solution that Europe’s decision-makers should stand behind. 

During the first phase of the debate, the focus was on the importance of improving therapeutic adherence by revealing the magnitude of the problem. The discussion highlighted that up to 200,000 patients die prematurely every year across Europe due to their inability to follow the details of a prescription. This costs the 28 European governments an additional €125 billion in healthcare services expenses. 

Patients, according to the panel discussion, do not stick to their prescribed drug intake due to a lack of communication with healthcare specialists and their difficulty in finding or understanding the information they need for a proper intake and their inability to afford the medication they need. Those that are affected include elderly people who with multiple medications and patients suffering from chronic or mental diseases.

Even though there are encouraging examples of countries where medical advice is easier for patients to access, such as in Belgium, where family pharmacists offer assistance to patients, the broader image across the rest of Europe is far bleaker. 

Spain, France, the Netherlands, and Sweden currently use dose dispensing tools and have seen positive results amongst patients that fail to adhere to their medication doses. In Sweden, dose dispensing was introduced in the 1990s manually as a centralised model,  though it is not an integral part of the country’s health system.

‘‘The costs that the Swedish government invests annually in the healthcare of patients that do not adhere to their medication can be easily saved with the implementation of dose dispensing as an integral element of healthcare systems to improve therapeutic adherence and medication access,’’ said André Sjöblom, the Representative of Swedish Dose Dispensing Wholesalers Svensk Dos. 

France has recorded surprising results with many of its patients having benefited from dose dispensing tools. As presented, the proportion of patients that stuck to their medication because of dose dispensing was up to 77% during the first month that it was offered, and 98% during the second month with dose dispensing.

Alexandre Valfer, a French community pharmacist, said that there is no regulation or financial assistance in France for dose dispensing, which forces health professionals to manage dose dispensing on their own during. 

In the wake of the panel discussion, policymakers are expected to look into what doctors, nurses, pharmacists and patients need to have a constructive dialogue about what patients need to better. The experts that gathered in Brussels said health professionals should be more open to having discussions with their patients and better respond to their specific needs. 

A consistent legal framework for dose dispensing remains elusive but is gaining some sporadic support as those in favour insist that improved standards via a unified, pan-EU system would reduce the number of premature deaths.

‘‘Disparities between national regulations should lead us to consider establishing a legal framework for dose dispensing as well as standards and guidance for member states on how to successfully implement such tools in their healthcare system. As decision-makers, we need to take into consideration these results, acknowledge that there is a therapeutic adherence gap, confront with all the relevant actors involved in the process, and offer to dose dispensing a clear regulatory environment across Europe,’ said Portuguese MEP Nuno Melo.

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