The behaviors and experiences of the community pharmacy team on the provision of multi-compartment compliance aids

Stewart, Derek; McDonald, Craig; MacLeod, Joan; MacLure, Katie; Gray, Gwen; McIntosh, Trudi

doi:10.1016/j.sapharm.2017.04.004

Cited by 6 publications

(9 citation statements)

References 20 publications

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“…. ( 5), (24) The pre-testing phase with cognitive interviews provided further methodological rigour (25). Notable limitations of cognitive interviews are selfselecting participants most commonly characterised by higher educational levels than average survey respondents.…”

Section: Discussionmentioning

confidence: 99%

“…A cross-sectional study of 26 community pharmacy staff in Scotland reported that pharmacists did not feel confident in assessing patients' needs for an MCA, nor whether they are capable of using it correctly. (24) The pharmacists' opinions taking precedence over the patient in determining the need for an MCA does therefore generate some concern, not only because pharmacists do not feel equipped to undertake this process, but also because patients should be central to decision making (30). Given that older patients in receipt of MCAs have reported negative experiences associated with this paternalistic approach to MCA initiation,(5) practitioners should attempt to engage patients with the decisionmaking.…”

Section: Discussionmentioning

confidence: 99%

“…(22) Notably, in the 2001 review of MCA provision patients were not cited as a source of MCA requests which contrasts the present findings and those reported from a recent Scottish survey. (24) The precision around the estimate of the prevalence of pharmacies in England providing MCAs should be interpreted in the context of a third of the targeted pharmacies not providing data regarding MCA provision. However, given that 95% of the purposively sampled 80 pharmacies were comparable, it is unlikely that the true proportion differs significantly.…”

Section: Discussionmentioning

confidence: 99%

“…A 12 item survey informed by the MCA literature was developed to fulfil the study objectives. (5), (24)Face and content validity of the survey were investigated through cognitive interviews (25) with a convenience sample of community pharmacists identified from the professional network of the authors. Cognitive interviewing allows evaluation of how the target audience perceives survey instruments and their constructs.…”

Section: Survey Development and Contentmentioning

confidence: 99%

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Quantifying and characterising multi-compartment compliance aid provision

Shenoy

Scott

Bhattacharya

2020

Research in Social and Administrative Pharmacy

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Survey Development and Contentmentioning

confidence: 99%

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Quantifying and characterising multi-compartment compliance aid provision

Shenoy

Scott

Bhattacharya

2020

Research in Social and Administrative Pharmacy

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“…According to a 2018 study 8 led by Derek Stewart, formerly of the School of Pharmacy and Life Sciences, Robert Gordon University in Aberdeen, it's less that community pharmacists are negligent, and more that they often come under huge pressure from prescribers to supply a compliance aid.…”

Section: Poor Evidence For Multi‐compartment Compliance Aidsmentioning

confidence: 99%

Do pill organisers improve medication adherence?

Dowden¹

2020

Prescriber

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Multi‐compartment compliance aids (MCAs) are pill boxes or blister packs that organise medication according to the day and time it needs to be taken. On the surface of it, they seem like the ideal way to ensure older patients take their medications as prescribed, but there is actually very little evidence to support their use and they may have adverse effects. This article looks at research into the effectiveness of MCAs, and discusses factors affecting medication adherence in general.

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