The use of the punch card and paper cups to dispense medications are no longer considered the norm in long-term care settings. Parata Systems PACMED onePAC compliance packaging offers health care facilities a convenient and safer alternative in medication delivery.

Currently, 10,000 beds in US long-term care facilities use the packaging system, said Meredith Sweeney, product manager for PACMED. Assisted living, skilled nursing, and group homes are examples of extended-care settings that are under the umbrella of long-term care.

"It makes obvious sense for long-term care because it allows you to be more compliant with drug regimens," said Tom Rhoads, executive vice president for customer and market strategies at Parata. The company acquired the US rights to sell PACMED in 2006 as part of its acquisition of McKesson APS.

Medication compliance is an issue clinicians face daily in the United States. Data indicate that noncompliance is the third leading cause of preventable death, comprises 10% of hospital admissions and 30% of assisted living and nursing home admissions, and costs an estimated $100 billion in annual health care costs.

OnePAC compliance packaging is personalized by the patient. Each unit- or multidose package contains all the information needed to ensure the right patient receives the right medications at the right time. The package can be customized with up to 19 lines that may include the patient name, drug name/strength/ description, and time of dose. Sweeney said that the 1 pack can fit 5 to 7 pills, depending on the pill size.

The advantages of the onePAC compliance packaging, operated by Server Plus software, include on-time medication-pass cycles, reduced medication-pass times, increased time for patient care, and reduced medication errors. Sweeney said feedback from the clinicians using onePAC has been "amazing." "They [clinicians] like it from the perspective that it's easy, especially in a group home."

Kelley-Ross Long Term Care Pharmacy has seen its benefits since it began using PACMED in May 2006. The pharmacy is 1 of 5 pharmacies that are part of Kelley- Ross & Associates. The company also operates 3 community/clinic-based pharmacies and a mail-service pharmacy.

Serving about 50 facilities in the greater Seattle, Washington area, the pharmacy fills approximately 9000 prescriptions on average per month. The system was chosen "due to the integration with our pharmacy management system and the potential for end-to-end integration with our facilities electronic medical records and dispensing systems," explained Brian Beach, PharmD, FACA, director of long-term care services.

The user-friendly system has allowed the pharmacy to "offer unit- and multi-dose packaging to our facilities that works well with weekly, biweekly, and monthly cycle fills. It also has provided full compliance with regulations through exact labeling and identification of each dose," said Dr. Beach.

A benefit of the onePAC is that it has allowed the pharmacy and facility to ensure that each patient gets the 5 rights of medication. "This is done through decreasing error rates by automating some of the repetitive tasks that are done in the pharmacy such as product selection and filling of selected packaging," he said.

Dr. Beach also added that being able to manage each prescription at the dose level is crucial for long-term care. "With the potential turnover of patients and changes in medications, it is very important to have direct control over medications in a day-by-day and dose-by-dose manner."

Parata offers 240-cell and 500-cell models designed to support pharmacies that service long-term care facilities. In an effort to bring the onePAC system to more retail pharmacies, PACMED has introduced the C30 model, which will feature 30 cells. Rhoads described the system as a smaller, less expensive model to offer the same type of packaging for patients.

With the new scaled-back model now available for pharmacies, community pharmacies in particular will be able to differentiate themselves with an innovative package that drives adherence. Nearly 25% of nursing home admissions result from a senior's inability to maintain a medication regimen at home. Converting to the onePAC system will enable caregivers to more easily monitor their relatives' adherence with every dose.