adherance Flashcards
(20 cards)
what is adherance aid
-any item which would help the user ‘comply’ with the correct taking of their medication
- Facilitate the self-management of medicines
- Used to simplify a medicine regimen
what is MCA
a repackaging system for solid dosage form medicines, such as tablets and capsules
what does the equality act of 2010 say, 3 things
- accessible to disabled ppl as well as everyone else
- medication adherence is considered reasonable adjustments
- the pharmacy contractor is responsible for assessing the need for a medication aid
do you have to give aid
If there is no disability, there is no legal requirement for an adherence aid to be provided to a patient. And it should not be presumed that a patient with a disability must always be supplied with one
5 advantages
Act as visual prompt/reminder to take medication
Reduce the complexity of adhering to a regimen
Promote independence
Can show that self-administration has taken place
Minimise dose, amount and timing errors
10 disadvantages
Risk from secondary dispensing errors
Do not improve intentional non- adherence
Only suitable for certain solid dosage forms and regimens
Long term stability of medicines in the MCA unknown
Potential hygiene problems for reusable MCA
Manual dexterity issues
there is inadequate space for instructions
potential interactions between medicines
not sufficent barrier fropm envipoornment
off lisence use and insufficent evidance on imapct oin medication
do you get paid for it
no
7 considerations about the medications
- Is the tablet packaged in a foil strip
- Are there desiccants present in the packaging?
- Is the tablet packaged in a glass container?
- Are the original blister packs darkly coloured rather than clear or white?
- How are the tablets coated? (sugar vs film-coated)
- What is the chemical structure of the drug (is it susceptible to hydrolysis)?
- Will more than one type of dosage form be included in the same compartment?
8 unsuitable medications
Effervescent, (oro)dispersible or chewable tablets
Buccal and sublingual dosage forms
Cytotoxic drugs and drugs that require safe handling
Products that require refrigeration
Dosage forms that will not fit into a compartment
Medicines to be taken ‘prn’
Medicines such as warfarin, where the dose is likely to vary
Medicines that need to be taken in a specific way
10 steps
Conduct an MCA suitability assessment
Assess medicines use
Discuss risks and benefits of MCAs
Check why they want an MCA (where they told/influenced to?)
Assess all alternative intervention options which can assist the patient to take their medicines
Ensure the carer (if one present) is adequately trained
Have an agreed plan, especially if using an MCA and the patient needs medicines that can’t be incorporated in an MCA
Involve follow up and regular review
Consider equality legislation
Record keeping to support decisions made
5 patient advice
The MCA is unlikely to be child-resistant and should be kept out of the sight and reach of children
They should be stored in a cool, dry place, out of direct sunlight (not bathrooms or kitchens)
They should not try to make any changes to the contents. Let the pharmacy know if the prescriber changes their medicines or doses
If the medicines are spilt or have moved compartments, not to put them back. Take them back to the pharmacy
Return any unused medicines back to the pharmacy for proper disposal
10 practical considerations
Packaging considerations
Labelling
Record keeping
Hygiene and contamination
Delivery
Frequency of supply
PILs
Understanding accountability
Controlled drugs
Identifying medicines within an MCA
expiration date
8 week expiry for products in sealed MCA (but check individual medicines)
Up to 7 days when in an unsealed MCA
what if there is a new precuicption
must make a brand new one
10 ways to fix memory reasons for non-comliance
Reminder systems which link in with a patient’s routine
Simplifying medication regimens
Telephone or text reminders
Medication reminder charts (MARS)
Alarm devices
Medication organisers which dispense medicines
Pill bottle top with last opened indicator and reminder alarms
Smart Phone medication reminder applications ‘Apps’
Multi compartment compliance aid (MCA) filled by pharmacy
diffulity in using
Medication review
Inhaler guides
Injecting Insulin guidance
complexity of regimen is an issue
Medication review
Weekly pill organisers (not filled by pharmacy)
Multi compartment compliance aid (MCA) filled by pharmacy
Swallowing difficulty
Alternative formulation
Tablet cutters and crushers
Manual dexterity issues
- Wing capped bottles
- Eye drop dispensers
- Pill presses
Problems with vision
- Labels with large print or pictograms
- Braille
- Magnifying glass
