AU664228B2 - A drug packaging, dispensing and management system - Google Patents

Description

"A DRUG PACKAGING, DISPENSING AND MANAGEMENT SYSTEM" This invention relates to a system which facilitates the sup ly, management and dispensing of drugs in rsdnilcr facilities, continuing care ffacilities, hospitals, uommunit.y homes and the Like. The system may also be used by ind-I'vichuals.

j 5 t manage druy administr-ation to themselves. The invention also -re~ates to packaging means for use in the system and to a method of managing and dispensing drugs using the system.

1he administration of medication to patients has always been a problem; particularly in institutions such as hospitals.

An early practice in these instituition~s was for a nursing sister to ydre-pour medication in a medication room. Tablets we.-e ojaced ill spiecial cups alld placedi on ice b:lock trays. The trays were then taken through the wards and each item of medcaLonwas admrinistered to the appropriate patient. This practice has many defects and is now illegal in many countries.

It is also common to use medication trolleys that Ihave Individual patient drawers. This system avoids pre-pouring of the medication but is extremely time consuming and labou.r intens-1ve for nursing sisters. Each time medication is to b:e 20 diisedthe n'ursiin9 sister Is faced with the task of ,topening hedrawer, removing the drug con'tainer-, taking the lid off the container, administering the medication, placing the lid back on the container and theni placing the container back in the droawc-. TAo repcat thio proecduz~o- for ar-arge number of 25 patients, each often t-aking more than one drug, often three ":.times a dayt is extremely time consuming and is not popular with nursing staff. Also mistakes can occur, frequently, An attrimpt to overcome these problems has been made b Manrex Australia Pty, Limited with a system called the Webstersystem (trade mark) *This system requiires nursing staff to supply the pharmaci.st with details of the medication required by each patient. Then, for each patient, the Pharmacist prepares the medication that is to be administered -2 at a set time by placing each day' s dosage in the cavity of a blister pack. usually the blister pack has 35 cavities and thereforre can be used to a min-ster -rugs for 3days.

A foil backing sheet is then heat sealed onto the blister pack to contain and protec:t the medication. The medication is removed from the blister pack by pushing it through the bao;king foil.

The blister pack is then pl~acedi in a folder that comprises t'wo panels joined at a fold. Each panel has apertures through it; the apertures of onie panel b~eing aligned wit~h those of the other when the panels are folded together.

The apexr uxres a'-so alLgn with Che b,:lister cavities so that mnedication can be removed by pushing a finger through an ayerture, breaking the backing foil, and pushIng the medication out of t-he aligned aperture of the other panel.

The apertures through one of the panels are numbered to pz-ovide a convenient administration sequence guide. Also various areas are left open on the paniel such that information labels can be adhered to it.

suc The panels also have a pair of punch holes through them suc that the folder can be securedi in a ring binider. 11n thi1 4,s wayr all medication to be administered to all patieznts in the morning (for example) is secured in a particular ring binder.

The nursing staff then dispenses the medication by placing all 25 the ring binders on a trolley and pushing the trolley through the wards or rooms. The nursing sister then rflicks to the folder containing a particular patient's medication, pushes the '2 medication from the folder, anid admiisters It to the patient.

The appropriate folder is then selected for the nat patient and tho process repeated.

L 7 3 *k The folders are colour coded such that all folders for any particular administration time have a common colour. For example medication to be administered in the morning is placed in green folders, medication to be administered at lunch time is placed in pink folders, and so on. It will be appreciated that at least one ring binder is required for each standard administration time.

The Webstersystem (trade mark) has greatly facilitated the administration of drugs to patients by nursing staff but requires a great amount of effort on the part of the pharmacist. The process of packaging the medication in the blister pack and heat sealing the backing foil is labour intensive. The pharmacist must by hand place each drug in a cavity until the blister sheet is full and then heat seal the sheet. Consequently each pharmacist can only service a relatively small number of institutions. Also the system is relatively expensive since the plastics folders are expensive. The process of flicking through the folders is also a problem since identification of any folder is not simple. Also overall management of the system is lacking.

Another form of the Webstersystem (trade mark) is available but this is even more troublesome for nursing staff. In this form, the blister pack has five columns of seven drugs each and each column is labelled for a particular administration time. Therefore any patient has only one folder but dispensing of drugs at any one time is made more difficult.

Accordingly it is an object of this invention to provide a system to facilitate packaging, management and dispensing of medication.

This invention provid-s a medication dispensing assemblage, suitable for a plurality of patients having potentially different medication requirements from each ther, but who receive medication at substantially the same 0 /times as each other comprising: /§1 r r ~I 4 folder means having identification means to identify a particular administration time, drug type or patient group, said folder having a binder means adapted to releasably hold a blister pack sheet containing a prescribed amount of drug, each sheet having identification means to relate it to a single patient and describing medication details; a plurality of individualised patient drug treatment charts containing identification means and medication information; and wherein each blister pack sheet has a cavity sheet made from a food grade plastic material, having a plurality of cavities formed therein, said cavities arranged in rows and clumps, and a backing sheet, the backing sheet having perforations alignable with respective cavities in the cavity sheet, and being a two part assembly, one part being a food grade plastics self adhesive sheet, the second a removable liner, perforated to provide on removal from the first sheet a series of retained segments of said liner which are not removed, but which adhere to the first sheet in a pattern registerable with the cavities of said cavity sheet on alignment therewith.

The invention also provides a method of assembling a medication dispensing assembly comprising: St forming a cavity sheet, being a series of cavities adapted to retain medication in a sheet of food grade plastic material; (ii) placing pre-determined amounts of selected drugs in said cavities; (iii) applying a liner to a self adhesive sheet of food grade plastic material, said liner having segments thereof perforated either before or after this application, in a perforation pjattern capable of conforming with the cavities formed in a .eet of step above;

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4A (iv) removing sufficient of the liner to expose the adhesive of the self adhesive sheet, but retaining those segments which have been perforated; aligning said liner with the cavity sheet of above so as to align the perforated segments in the retained liner with the cavities in the cavity sheet to thus form a blister pack; (vi) releasably mcunting the medicament containing sheets within a folder and; (vii) releasably mounting in said folder information sheets relating medicaments with intended recipients.

The invention also provides a method for the preparation and dispensation of medicaments comprising: the preparation by a dispenser of medicaments of a Medicaments Schedule of patient identification, drug type and dosage regime; (ii) the transfer of this information to a drug treatment chart; (iii) the preparation of a medication dispensing assemblage '620 above containing designated medicaments in a or several blister pack sheets; (iv) the placement of the, or several, blister pack sheet(s) in folders by dosage time; the manual breaking of the appropriate blister pack sheet(s) and dispensation to the patient.

The retained segments may have perforations through the liner but not through the plastics, defining a region of S weakness for perforation and extraction of the contents of the avity.

i r 7 i- 4B Preferably, the backing sheet is a heat shrunk thermoplastics sheet.

Preferably the blister pack has identification means to identify the administration time, the patient and/or the drug and dosage. The identification means may be in the form of labels adhered to the blister sheet.

The blister sheet may have printed indications or directions on it to provide guidance to the sequence in which the drugs in the cavities are to be taken. The blister sheet tO may have 31 recesses to provide 31 cavities in the blister pack. Therefore a drug can be packaged for each day of a month.

Preferably the blister pack is pre-prepared by a drug manufacturer or distributor and distributed to pharmacists; there being a different pack for each standard dosage of the drug. The pharmacist may then select the appropriate blister pack from a supply and adhere to it patient and administration identification labels.

i-i The drug treatment instruction sheet may also include information. concerning dxrugs that cannot be packaged in a bliater pack and drugs that are to be administered at irregular times.

The folder itteanis may have bound inl iU a plurality of blister packsl one for each drug that is to be adiitvdto the patient.

The folder meiians may have bound in it a drug instruction sheet containing information concerning drugs that are to be administered over a short period, Preferably the identification meanis on the folder means to identify the administration time is a colour; the foldezmeans being coloured in the colour. The identification label 4 on the blister sheet is preferably the same colour.

A CssetLte case containing a video-cassette giving instruct ions to visually impaired people may be secured to the Inside of the cover of the folder means. Similarly, additional information may be provided by way of video-cassette or compact a dIsc, and these may be secured within the folder also.

Th.e lnventioni also provides a drug dispensing and management system for a patient that comprises a plurality of folder packages as described above; each. folder package being clearly distinguishable from any other and each folder package .1 a a.:a.containing drugs to be administered at. a partirular time or containing particular drugs, 4aThe invention also provides a Method of storing and managing drugs to be admiiitered to a patient; the method omrsig -6 forwardi.ng to a pharmacist facility a drug treatment instruction sheet that idelltifies a patient, a drug, a dosage and an administration time; i l s e ak t a at the pharmauist faciiity, selectingabitr akta has a plurality of sealed cavitie8 each containing the drug in the appropriate dosage, the blister pack oomprising a blister shee. h*.aving a tearable b)acking sheet adhered to it; and ,xeleasably bindin the b lister pack and the drAug inist.--tcton sheet in a folder means that has identification meauns to ildeiitify thje patient; and administration time or drug type.

Preferably a plurality off drug treatment instruction sheet s are forwarded to the pharmaist facility and a folder means EOT, each administration time is prelpared.

Mm1boaiments of the invention are now described, by way C ex~amrple only, with reference to the drawiq1ngs in which-, Figure 1 illustrates, in schematic fovim, one embodiment of a folder means; rigure 2 is plan view of the folder means; and '20 Figure 3 illustrates a drug treatment chavt for use in the 9 system.

Referring to Figures I, 2 and 3, the folder means T comprises a ring file 12 that has a ring binder 14 attached to its rear panel 16. The ring file 12 is a standard ring rile comprising a rear panel 16, a spine panel 19 and a front panel The ring file 12 is plastics coated arid aolouved.

A second ring binder 18 is attached to the front pariel of the rin4 file 12 adjacent its upper edge 22, The ring Zile 12 forms a means by which all. medication to be adinJ.itered to 7 a patient at a particular time can be stored. Also, for particular types of medioation that; must be administered separately, the ring file 12 forms a mneans in which to store the medication for a patient.

in a furthler preferred embodiment (not shown) a 4-ring binder is employed.

A medication blister sheet 24 is releasably secured in the ring file 12 on the ring binder 14. The blister- sheet 24 is a rJleaL sheet made of plastics and has a plurality of blister cavities 26 vacuum formed in it. The bliuter' cavities 26 ave ar!rangjed in r~ows and columns. Each cavity 2G has a number above it to provide qmidanoe on the seq~uence in which drugs contained in the tcavities are to administered. The blister sheet 24 illustrated in Figure I. has 31 cavities.

The cavities 26 are illustrated to be cir.cular in crosssection but they oan be any suitable shape. For e xamplet if the drugs are rectangular, the cavIties 26 can be rectangular.

A pair of apeLrtures 30 are formed thirough the sheet 24 adjacent he inner edge 28 of the blister sheet 24. The apertures 30 aire spaded from one another to align with the spikes 32 ot the ringq binder 14, The blister sheet 24 has a label field 34 adjacent its upper edge 36. A label indicating the time of day or the medication to be administered is adhered in the label field 34. Further label Cields 38 are provided adJacent- the lower edge 40 of the blister sheet 24 so that 4labels containing further Information can 1:e adhered to the blister sheet 24, F'or use with the 4-ring binder, 4 apertures 30 are punched n the sheet 24.

8- A thermoplastic sheet 42 is adhered to the back of the blister sheet 24 to hold the medication in the blister cavities 26. The thermoplastic sheet 42 is made of a heat sensitive plastics material that shrinks onto the blister sheet 24 when heat is applied. In this way the sheet 42 seals the blister cavities 26. The sheet 42 has perforations 44 in one of its faces; the perforations not extending completely through the sheet 42. These perforations 44 are arranged in a pattern so that they align with the blister cavities 26 when the sheet 42 is heat shrunk on the blister sheet 24. In this condition, the perforations 44 face the exterior of the blister cavities 26.

Tablets, pills or capsules contained in the blister cavities 26 can be removed by pushing them through the thermoplastics sheet 42; the perforations 44 facilitating tearing of the thermoplastics sheet 42.

In a further preferred embodiment the backing sheet is made up from a plastic sheet and a liner. The plastic sheet is self adhesive, or heat sealable, or a combination thereof. It seals the cavity, with a food grade plastic. It can be translucent, clear to permit visual identification or confirmation of the drug contents, or opaque to prevent damage by ultra violet light, as the user may elect.

S It is backed by a liner, which can helpfully be of contrasting co:,our, and which has an exterior perforation line defining a i'o segment, and one or several interior perforations providing a weak point to facilitate tearing of and then opening of the blister pack cavity.

The thermoplastic sheet 42 has a pair of apertures 46 through it adjacent its inner edge 48. The apertures 46 align with the apertures 30 of the blister sheet 34. In use lines of adhesive 47 are placed on the face of the thermoplastic sheet 42 adjacent three of the edges. The thermoplastic sheet 42 is then adhered to the blister sheet 24 after a drug has been Sse/specs/667 920

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I- -9placed in each cavity 26. Hot air is th-en blown onto the thermoplastic sheet 42 to cause heat shrinking so that the blister cavities 26 can be sealed and so that the thermoplastics sheet 42 adheres to the blister sheet 24. The adhesive 47 prevents slippage of the thevmoplastics nheet 42 while 1 1 is being heat shrunk.

The ))lister packs are conveniently made up by the pharmaceatical company or a drug distributor in a variety of standard doses. in this way, a pharmacist ed not make up the packr. it will be appreciated thaz pharmacetitical companies package many drugs in this form (for example headache t~abletst contraceptives, anti-allergy tablets anid the like) and therefL-ore it will not be a problem to extend the range.

A drug treattnt c hart 50 (best illust;.-i-ed in Figure 3) is positioned in a clear plastics sheet envelope 52. The sheet envelope 52 has a pair of apertures 54 thrjugh it adjacernt its inner edge 56, The apertures 54 are spaced apart to align with the s;pikes 32 of the ring binder 14. 'Phe sheet envelopu 52 is conventional.

For use with the 4-ring binder, 4 apertures 54 are provided.

The drkig treatment chart 50 is a paper or oardiboard sheet that forms a patient and medication reference chart to assist in packaging of medication and administration of the medication. The uipper portion 60 of chart includes fields 16 25 for patient and doctor identification. For example, the patient's photograph, name, ward and bed number, sensitivities and the doctor's name can be entered here. Also any pertiLnent notes and the date the request is forwarded to the pharmracist can be entered.

The chart 50 also has an information area 62 containing fields for Information concerning medication to be administe're -10iS from the blister sheet 24 in regular doses. This information area 62 forms the instructions to the pharmacist on what to package in a blister sheet 24 for each administration time for the patient.

The information area 62 has a date started field 64 and a dote discontinued field 66. Also included are fields for J identification ot the drug, the dosage amount and the administration time. The sheet 50 illustrated has an administration time field for each of a number of times.

The drug treatment chart 50 also has a further information area 68 containing fields for information S concerning medication that is administered regularly but the S medication not being in a blister pack. This information area 68 is substantially identical to the infurmation area 62 and provides instructions to the pharmacist to make up medication J which is not suitable for packing in a blister sheet.

The rear (not shown) of the drug treatment chart 50 may include further fields to provide infoxmation concerning medication that is not administered regularly. The pharmacist again makes up this medication in accordance with the instructions.

An intermittent drug treatment chart (not shown) may be Clipped to the ring binder 18. This chart lists information concerning medication for short term therapy. These medications can also be packaged in blistur sheets 24.

The outside (not shown) of the spine panel 19 has a clear plastics sleeve adjacent its lower edge. An information inoert that identifies the patient can be inse:ted into the sleeve.

In use a drug treatment chart 50 is completed for a particular patient and signed by a doctor, Drugs that can be 11 administered in blister packs are identified in the information area 62 and those that are not suitable for packaging in blister packs are identified in the information area 68. Also the dosages required and the administration times required are indicated. A separate drug treatment chart 50 is filled out for each administration time and for each patient. The drug treatment charts 50 are then supplied to a pharmacist who then makes up the medication that is not to be packed in a blister pack. If available, the pharmacist then selects the appropriate pre-packed blister pack containing the required medication in the correct dosage. These blister sheets 24 uan be conveniently made up by the drug company supplying the drug or the company's wholesaler or distributor. Plainly the blister sheets 24 will contain the drug in a standard dosage of which there may be any number,

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The pharmacist then attachts an appropriate administration time label in the field 34 and attaches labels giving administration instructions in the fields 38. The blister pack is then slipped into a ring folder 12 that is colour coded for the particular administration time or a particular drug. The drug treatment chart 50 for that administration time or drug is then also placed in the ring file 12.

.4ri ~If more than one drug is to be administered/ a blister pack for each drug is placed in the ring file 12.

0 f Alternatively, if certain drugs are usually administered together, the pharmaceutical manufacturer or distributor may pre-package these drugs together in a blister pack 52 in standard dosages.

Each patient may have a separate ring file 12 for each administration time and, in some instances, for a particular drug (for example, antibiotics must be administered separately). However, it is practical to place blister packs i jj I -12 for multiple patients within the one folder. Thus, all patients requiring medication at say, lunchtime, may have the appropriate blister packed dosages with identifying information within one or a small number of folders.

Therefore when the nursing staff do their rounds, all the folders for a particular administration time or drug can be placed on a suitable trolley, When the appropriate patient is reached, the appropriate ring file 12 is removed and the drug or drugs administered. The medication that cannot be blister packed, will also be carried on the trolley and administered at that time; the drug treatment chart 50 indicating to the nursing staff what needs to be administered.

In certain cases the drugs will be such that they are not convenient to be pre-packed by the pharmaceutical manufacturer S" 15 or distributor. This might occur when these drugs are not Sadministered in standard dosages. In these cases the pharmacist can prepare the blister packs by placing a required dosage in each cavity 26 of a blister sheet 24, adhering a backing sheet 42 to it and heat shrinking the backing sheet 42.

However a large majority of the drugs can be pre-packed by the manufacturers or distributors. In this way a large portion of the labour intensive component of the Webstersystem (trade .ir mark) is done away with. Also storage, management and dispensing of the drugs by the nursing staff is greatly 25 facilitated since each patient's drugs are stored separately in S a folder for each administration time.

Although tablets, pills and capsules are most suitable for use in the system, drugs in other forms can be stored in blister packs. For example drugs in the form of suppositories creams and lotions can be stored in blister packs. However drugs in liquid form would require some adjustment to the standard blister; for example the use of small containers in the blister pack.

t. 13 This system is particularly suited for use in homes for the aged where patients are resident for long periods of time and are administered certain drugs daily. However the system can also be used in hospitals and the like where patients will remain for short periods and the drugs and dosages would be more varied. The system can also be used by patients at home who are required to undergo a drug treatment programme.

It will appreciated that the system provides a neat and convenient storage, management and dispensing system. The folders can be neatly stored in shelving and rapidly located.

Also dispensing of the drugs by the nursing staff is greatly facilitated. Apart from the initial outlay for the ring files, the cost of the system is relatively low.

It is to be understood that the invention is not limited to the bodiment described in the specification and numerous modifications can be made without departing from the scope of the invention as defined in the following claims.

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P~Lu se/specs/667920 1h..

Claims (15)

1. 2. A medication dispensing assemblage as claimed in claim 1, in which the retained segments have perforations through the said liner, but not through said plastic, defining a region of weakness for perforation and extraction of the contents of said cavity.
2. 3. A medication dispensing assemblage as claimed in claim S1, having a second binding means to retain sheets other than I- the blister pack sheets.
3. 4. A medication dispensing assemblage as claimed in claim 3 in which said sheets are therapy charts for the prescription of intermittently dispensed drugs.
4. 5. A medication dispensing assemblage as claimed in claim 1, having an alternative binding means adapted to retain any one or more of a video cassette, an audio cassette or a compact disc containing patient and/or drug dosage information.
5. 6. A medication dispensing assemblage as claimed in any one of claims 1 to 5 substantially as herein described, with reference to any one of the accompanying drawings.
6. 7. A method of assembling a medication dispensing assembly comprising: forming a cavity sheet, being a series of cavities adapted to retain medication in a sheet of food grade plastic material; (ii) placing pre-determined amounts of selected drugs in said cavities; hi (iii) applying a linar to a self adhesive sheet of food grade 0 plastic material, said liner having segments thereof perforated either before or after this application, in a perforation pattern capable of conforming with the cavities formed in a sheet of step above; (iv) removing sufficient of the liner to expose the adhesive of the self adhesive sheet, but retaining those segments which have been perforated; aligning said liner with the cavity sheet oi above so as to align the perforated segments in the retained liner v with the cavities in the cavity sheet to thus form a blister 830 pack; *i 16 (vi) releasably mounting the medicament containing sheets within a folder and; (vii) releasably mounting in said folder information sheets relating medicaments with intended recipients.
7. 8. A method as claimed in claim 7 in which the perforations provide a series of segments which are retained and which provide a close register with the. cavity with which they are aligned.
8. 9. A method as claimed in claim 7 or 8 in which human or ±0 machine readable indicia are printed onto the blister pack. A method as claimed in claim 7 having the additional step of mounting intermittent drug therapy charts within the folder.
9. 11. A method as claimed in any one of claims 7 to 10 having the additional step of mounting any one or more of a video cassette, audio cassette or a compact disc within the folder.
10. 12. A method as claimed in any one of claims 7 to 11 in which the blister pack or packs selected for each patient are selected from pre-packaged stock of such blister packs.
11. 13. A method as claimed in any of claims 7 to 12 substantially as herein described with reference to any one of the accompanying drawings.
12. 14. A method for the preparation and dispensation of medicaments comprising: the preparation by a dispenser of medicaments of a Medi(,aments Schedule of patient identification, drug type and dosage regime; (ii) the transfer of this information to a drug treatment a 17 chart; (iii) the preparation of a medication dispensing assemblage as claimed in claim 1, containing designated medicaments in a or several blister pack sheets; (iv) the placement of the, or several, blister pack sheet(s) in folders by dosage time; the manual breaking of the appropriate blister pack sheet(s) and dispensation to the patient. A method as claimed in claim 14, in which step (iii) is substituted for by the selection of a stock of pre-prepared blister pack sheets.
13. 16. A method as claimed in either claim 14 or 15, in which all medication for patients for dispensation at the same time is grouped together with identifying information in a folder identified by indicia as to that time.
14. 17. A method as claimed in claim 16, in which the indicia is the colour of the folder.
15. 18. A method as claimed in any one of claims 14 to 17 herein, substantially as herein described, with reference to the accompanying drawings. DATED THIS Seventh DAY OF December, 1994 KENNETH CHO SZETO BY PIZZEY COMPANY PATENT ATTORNEYS ABSTMCT The Jinvent-jin provides a medication dispensing assembly, a mnethod Of manvfacturing sajid assembly, and a method of using it for drug admin3.8tration, Blister pack cont~aining prescribed doses of drugs may be yire-preparedf or made to suit, and placed in a folder, together with inntructions for dispensation medication for paticni.s requirirng potentiall~y different medication dispersal at the same time, say at breakfast, can be easily grouped within a folder and dispensed. The invention also provides for combination of drug txreatment charts, intermittent drug clicrts and partial information with the appropriate doses of medication. 44 4 4 04 44 iA