Complex medication regimens: supporting adherence

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Interventions and tools to help improve medication adherence, where complex regimens (capability) have been identified as a factor

Medication review

There is evidence that reducing the number or frequency of medicines where possible can improve adherence. Healthcare professionals may find our selection of tools and resources helpful when undertaking medication review.

Pill organisers

Weekly pill organisers filled by the patient or their relative or friend (not by pharmacy) helps to keep the patient in control and allows for changes to be made if the prescription changes.

Patients (or their relatives or friends) should be advised by their pharmacist on the suitability of their prescribed medicines for a pill organiser. Pharmacists may need to provide support and training on selecting and using these organisers safely.

There are many types available that come with a various number of compartments and generally enough capacity for one weeks’ worth of medication. They are widely available to purchase from local stores, pharmacies and online (search for ‘pill organiser’).

Various other compliance aids are available. The SPS Reminding to take medicines page provides information on interventions and tools to help improve medication adherence where memory issues have been identified as a factor.

Multi-compartment compliance aids (MCAs)

Multi-compartment compliance aids filled by pharmacists should not be used routinely. The risks of using MCAs are widely documented and their benefit in relation to medication adherence is unknown. Unless there is clear, explicit rationale for the use of MCAs, the default should be to supply medicines in their original packaging.

A small number of patients may be eligible to have an MCA filled by a pharmacy. For example, an older person with mild cognitive impairment who has a complex but stable medication regimen and limited support from family and friends and no carer may benefit from an MCA. Where more than one member of a household uses an MCA, each person’s MCA should be clearly labelled to facilitate differentiation.

Different pharmacies provide various products and options should be discussed directly with the chosen provider if a patient is assessed as being in this group.

Visit our Medicines in Compliance Aids Tool for stability recommendations for tablets and capsules.

The Royal Pharmaceutical Society have published an MCA Pharmacy Guide.

Update history

  1. Sentence added about clear labelling to facilitate differentiation where more than one member of a household uses an MCA.
  1. Published

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