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(blister pack blister package)
50 results
  • Patient-specific blister packaging IQWiG Reports – Commission No. A18-35 [BOOK]
    Institute for Quality and Efficiency in Health Care (IQWiG): Cologne (Germany) Institute for Quality and Efficiency in Health Care (IQWiG) BOOK
  • CONCLUSIONS: PSBP as an option for simplifying drug dispensation to nursing home residents has long been the subject of intensive and controversial discussion. On the one hand, potential advantages of PSBP are cited (e.g. improved drug therapy safety, relief of nursing staff and an associated increase of the individual quality of care, and hence satisfaction of residents with their care). On the other hand, the process is associated with potential problems (e.g. nursing staff losing familiarity with drugs, numerous drugs that cannot be blistered, loss of patient autonomy). Despite the intensive debate, this Rapid Report found few (7) prospective comparative studies when mapping the evidence on PSBP. Six of these studies were randomized controlled trials (RCTs). All of the studies were conducted in the outpatient setting, and each answered specific research questions (e.g. blister packaging of certain drugs or for patients with specific diseases). None of the studies were conducted in Germany. No prospective interventional study was found which investigated the research question of interest, the benefit of PSBP in the inpatient (nursing home) setting. Since drug dispensing to patients in these studies differed considerably in the outpatient versus inpatient settings (e.g. regarding medication management and age structure), the results of outpatient studies are not transferable to the inpatient (nursing home) setting. Overall, there is no hint of (greater) benefit or (greater) harm of PSBP in comparison with drug dispensing without PSBP in the inpatient (nursing home) setting. In addition, insufficient evidence is available on drug dispensation using PSBP in the inpatient (nursing home) setting as regards costs, the time spent by nursing staff, and scenarios (different blistering processes and sites, level of digitization in nursing homes, blister packaging for patients on stable versus unstable regimens, complete or partial blister packaging of the medication with continued need for manual dispensing [certain dosage forms, acute medications] and resources needed when switching medication). The data provided in the literature should be considered highly unreliable. The analysis performed as part of the Rapid Report is based on many assumptions and pragmatic approaches. No sound conclusions can be drawn. The identified studies described potential cost savings associated with PSBP due to reduced wastage in case of tablet-based (rather than pack-based) billing as well as time savings for nursing staff. Additional expenditures are incurred to the statutory health insurance (SHI) when blister packaging is remunerated. Currently, the billing of blister-packed drugs is not uniformly regulated by law. On the basis of the currently available data, it is difficult to prepare a comprehensive assessment. Overall, due to a lack of valid data, the cost-effectiveness of drug dispensation using PSBP in the inpatient setting cannot be conclusively assessed. The considerations presented in this report provide examples of the interactions between the remuneration of blistering services and savings due to reduced wastage. Beyond the lack of reliable data, it should be mentioned that it was not possible to consider other care-related expenditures, for example costs incurred to the SHI for outpatient physician contacts or hospitalizations, which may be affected by blister packaging. Further, exclusively the costs of the blistered drugs were considered. In summary, further research is clearly needed to answer questions about the patient-relevant benefit of PSBP, its effects on nurses’ professional competence and work-related quality of life, indicators of drug therapy safety, and economic aspects of blister packaging. Reliable studies must be designed and carried out to determine whether and how the care of patients in nursing homes would be affected by the use of PSBP. To answer the research question of the benefit assessment, an RCT would be preferable. In addition to investigating the benefit and harm of PSBP, such a study could simultaneously determine the costs of care and nurses’ time spent. This report includes a suggested study design for such a trial.
  • Aspiration of a drug in a blister pack. [Case Reports]
    Respirol Case Rep 2019; 7(9):e00492Mori M, Kusanagi K, … Hanagiri T
  • We report a rare case of aspiration of a drug in a press-through package (PTP) treated by not just pulling it but using a unique technique. A 73-year-old woman was referred to our department because of a persistent cough resulting from aspiration of a PTP. Flexible bronchoscopy identified the PTP in the trachea immediately above the carina. Just pulling the centre of the PTP edge with biopsy forc…
  • Evaluation of the extent of damage to the esophageal wall caused by press-through package ingestion. [Journal Article]
    PeerJ 2019; 7:e6763Tamura T, Okamoto H, … Sugiyama D
  • Press-through package (PTP) is the most common accidentally ingested foreign body in Japan. Accidental ingestion of PTP can result in esophageal damage. An approach for evaluating the risk of esophageal injury has not been established. Therefore, we used porcine esophageal tissue and silicone sheets to establish a method for assessing the risk of esophageal damage on accidental PTP ingestion. We …
  • Multiple intestinal perforations due to blister pill pack ingestion. [Case Reports]
    BMJ Case Rep 2018; 2018Simo Alari F, Gutierrez I
  • A 72-year-old woman with morbid obesity and history of psychosis attended the emergency room due to abdominal pain. CT scan revealed a mesenteric infiltration surrounding a thickened wall bowel agglomeration; inside, a dense 2 cm foreign body with no pneumoperitoneum or peritoneal effusion. Surgery revealed four contained bowel perforations due to a blister pill pack inside the ileum; consequentl…
  • Validity of the days supply field in pharmacy administrative claims data for the identification of blister packaging of medications. [Journal Article]
    Pharmacoepidemiol Drug Saf 2017; 26(12):1540-1545Leong C, Sareen J, … Chateau D
  • CONCLUSIONS: While the NPV was high, the PPV for identifying blister packaging using the days supply field in pharmacy claims data was modest given the low prevalence in blister pack use. The best predictor occurred when 28 days was compared with 30 days. KEY POINTS Blister packs are arranged in 4 × 7 compartments and are often used to improve adherence, but no studies have examined whether it was possible to identify the use of blister packs using the days supply field in pharmacy claims data. Findings show that a 28-day supply yielded a high sensitivity and specificity for identifying the use of blister packaging compared with a 30-day supply, but there is potential for misclassification. Future studies directed at examining subgroups that are more likely to use blister packs and replication of findings using other data sources in other jurisdictions are encouraged.
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