Care homes: the move away from using monitored dosage systems

摘要

IN MOST care homes, monitored dosage systems (MDSs) are a part of everyday life. But in recent years, things have started to change. Opinion is growing that MDSs, which are increasingly referred to as multicompartment compliance aids, are not the best solution for managing medicines, and care homes are beginning to switch to having medicines dispensed in original packs. It is a trend that looks certain to grow. In March 2014, the National Institute for Health and Care Excellence produced a comparison between MDSs and original packs in its guideline on managing medicines in care homes. For medicines administration, NICE found the advantages of MDSs are they that provide an additional visual safety check for care staff and can help facilitate self-administration. In comparison, the list of advantages for original packs is somewhat longer (see Panel 1). NICE did not find any disadvantages for administration in original packs, but listed a number of disadvantages to MDSs. This reflects guidance produced last year by the Royal Pharmaceutical Society on the better use of multi-compartment compliance aids. It states: "The use of original packs of medicines, supported by appropriate pharmaceutical care, should be the preferred intervention for the supply of medicines in the absence of a specific need for a multicompartment aid in all settings." The year before, an RPS report on care homes stated: "MDSs met safety needs in the 1980s but since the introduction of patient packs in 1991 their value has to be questioned."