Supporting with medication from different types of packaging
Service users should be supported with medication in a personalised way, balancing their wishes, needs and risks.
Original packaging (which is how a community pharmacy usually supplies medicines for people i.e., in a box or container with a pharmacy label including instructions,) is the preferred method of dispensing according to the Royal Pharmaceutical Society (RPS.)
Multi-Compartment Compliance Aids (MCA) or Monitored Dosage Systems (MDS) or Dosette, as they are sometimes referred to, is a general term for a device designed to contain individual doses of medicines in separate compartments or blisters. These can sometimes be useful as a tool to aid self-management of medication. However, they should not routinely be requested by providers where staff are supporting with medication as this is not a personalised approach.
Managing medication: A guide to help health and social care workers in conversations with people
The chosen method of support should always ensure that the following '6 R's' of medication support, which are promoted by CQC, can be demonstrated:
- Right person
- Right medication
- Right route
- Right dose
- Right time
- Right to refuse
Demonstrating that the '6 R's' have been followed can be more challenging and time consuming if the support is from an MCA because it is difficult to differentiate one medication from another when using an MCA. This can be particularly challenging when recording to evidence that each individual medication has been given.
Other examples of challenges from using MCA's include:
- Not all medicines can be supplied in an MCA such as dispersible aspirin which needs to be individually identifiable so that it can be dissolved in water. Also, some medicines lose their effectiveness if removed from the manufacturers packaging. Consequently, if a person has medicines that are not suitable for an MCA this can potentially create more confusion and missed medicines.
- Can lead to wastage/increased costs if not used correctly or when medicines change.
- Not able to know special instructions such as if medicines should be taken with or after food.
- Medicines that are outside of the blister pack may be forgotten such as liquid medication.
- MCA's have fixed times of day for when medicines are taken and cannot accommodate specific dosing instructions, for example, medicines to be taken on an empty stomach or with food are often in the same section.
Please note that pharmacies are not required to provide medicines in MCA's and some pharmacies may charge for doing this.
Further guidance
Multi-compartment compliance aids (MCAs) in adult social care | Care Quality Commission (cqc.org.uk)
Ensuring appropriate use of monitored dosage systems | NICE
Use of multi compartment compliance aids (MCAs) | RPS (rpharms.com)