Background: 64 million pharmacy filled multicompartment medication
compliance aids (MCAs) are dispensed by pharmacies in England each year
as a method to improve medication adherence. Despite the widespread use
of MCAs and evidence that their use may be associated with harm there is
no national consensus regarding MCA provision by acute hospital Trusts
in England. Aim: To determine current practice for initiation and supply
of MCAs in acute hospital Trusts in England and the potential
consequences for patients and hospitals. Methods: A 26 item survey was
distributed to all acute hospital Trusts in England. The questionnaire
covered policy, initiation, supply and review of MCAs; alternatives
offered; and pharmacy staffing and capacity related to MCAs. Results: 72
out of 138 (52%) Trusts responded to the survey. 60/70 (86%) had a
policy for the provision of MCAs. 33/55 (60%) that supplied MCAs on
discharge supplied a different prescription length for MCA vs. non-MCA
prescriptions. 49/55 (89%) Trusts provided only one brand of MCA. 47/55
(85%) MCA-supplying Trusts identified frequent difficulties with MCAs
and 13/55 (24%) reported employing staff specifically to complete MCAs.
30/35 (86%) MCA-initiating Trusts had an assessment process for
initiation, with care agency request as the most common reason.
Conclusion: There is a lack of a national approach to MCA provision and
initiation by acute hospital Trusts in England. This leads to
significant variation in care and has the potential to put MCA users at
an increased risk of medication related harm.