Quantifying and characterising multi-compartment compliance aid provision |
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| Affiliation: | 1. Dalhousie University, Nova Scotia Health Authority, c/o Sherri Fay, 2557, Veterans'' Memorial Building, 5955 Veterans'' Memorial Lane, Halifax, Nova Scotia, B3H 2E1, Canada;2. Aging Well with Marjorie, c/o Sherri Fay, 2557, Veterans'' Memorial Building, 5955 Veterans'' Memorial Lane, Halifax, Nova Scotia, B3H 2E1, Canada;3. Horizon Health Network, Research Engagement Manager, 5DN - Research Services, Saint John Regional Hospital, PO Box 2100, 400 University Avenue, Saint John, NB E2L 4L2, Canada;4. Dalhousie University Department of Medicine (Geriatrics), Nova Scotia Health Authority, Division of Geriatric Medicine, 5955 Veterans'' Memorial Lane, Suite 3310 Veterans'' Memorial Building, Halifax, NS B3H 2E1, Canada;1. LIU Pharmacy, 75 DeKalb Avenue, Room LLC405, Brooklyn, NY 11201, United States;2. LIU Pharmacy, 75 DeKalb Avenue, Room L306, Brooklyn, NY 11201, United States;3. Belmont University College of Pharmacy, 1900 Belmont Boulevard, Nashville, TN 37212, United States;1. Dipartimento di Ingegneria Industriale (DII), Università degli Studi di Napoli Federico II, P.le Tecchio 80, 80125 Napoli, Italy;2. Facultad de Ciencias Económicas y Empresariales, Universidad de Navarra, Campus Universitario, 31080 Pamplona, Spain;1. School of Medicine, Deakin University, Geelong, Victoria, Australia;2. Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia;3. Centre for Medicine Use and Safety, Monash University, Parkville, Victoria, Australia;4. School of Pharmacy, The University of Sydney, Camperdown, New South Wales, Australia;5. School of Medicine, Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia;6. University of Sharjah, Sharjah Institute for Medical Research and College of Pharmacy, Sharjah, United Arab Emirates;7. CSIRO Health and Biosecurity, Parkville, Victoria, Australia;8. Heart Research Institute/Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia;9. Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia;1. School of Pharmacy and Pharmaceutical Sciences, Cardiff University, King Edward VII Avenue, Cardiff, CF10 3NB, UK;2. Chief Pharmaceutical Officer, Welsh Government Offices, Cathays Park, Cardiff, CF10 3NQ, UK;3. National Pharmacy and Medicines Management Lead, NHS Wales Informatics Service, Cardiff, CF11 9AD, UK |
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| Abstract: | BackgroundMedication compliance aids (MCAs) to support adherence lack evidence for cost-effectiveness yet a 2001 survey in England estimated 100,000 patients receiving an MCA whilst living in their home.Objective(s): To obtain a contemporary estimate of MCA provision by community pharmacies in England and describe factors influencing pharmacist decision-making regarding MCA initiation.MethodsA stratified random sample of two community pharmacies per county (n = 40) in England were surveyed by telephone and a more detailed postal survey sent to participants expressing an interest. Data were collected to determine magnitude of MCA provision and, professional and administrative factors influencing initiation were reported as percentage (95% confidence interval) respondents reporting a factor.ResultsAn estimated 273,529 MCAs are filled by community pharmacies in England with a median (IQR) of 20(10, 50) MCAs per pharmacy per month provided for patients living in their home. Practitioners' judgement of appropriateness for MCA initiation was reported by 51.3 ± 11% as the primary factor influencing decision-making relative to 16.3 ± 8% and 20 ± 8.8% reporting patient's and carer's opinion respectively. Some form of assessment tool was reported by 13 ± 7.3% respondents.Postal survey respondents (n = 31) indicated that decision-making regarding MCA initiation was often or always affected by suitability of medication for dispensing in an MCA by 58% ± 17% of respondents; 74.2% ± 15.4% and 53.3% ± 17.9% of respondents’ decision-making was never or rarely affected by the risk of adverse events and reduced patient autonomy arising from an MCA respectively.ConclusionsProvision of MCAs by pharmacies in England has more than doubled in the past decade. Beyond considering the practicalities of whether an MCA is suitable for a patient, there is limited evidence of pharmacists considering patient choice or risk of adverse events arising from sudden increased adherence prior to initiation. |
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| Keywords: | Cost Dossett Compliance aid Pill organiser Assessment Determinants Influencers |
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