Multi-compartment compliance aid use among residents of very sheltered housing in the NE of Scotland
Funding BodyNHS Grampian
Multiple case studies were conducted in NE Scotland focusing on VSH residents aged ≥65 and using an MCA for ≥6 months. Residents were invited and consented to take part in a 15 minute audio-recorded, semi-structured interview. Questions were based on 14 domains of the Theoretical Domains Framework (TDF) relating to purpose, utility and management of medicines to identify determinants of MCA use. Residents participating also identified people in their care team for interview. Verbatim transcripts were analysed independently by 3 researchers using the Framework Approach.
Twenty interviews were conducted with residents at three sites (A,B,C). Further interviews were conducted with people in the residents care team: formal carers (17), GPs (8), pharmacists (8) and one family member. Findings indicate consensus around purpose of MCAs (knowledge) with varying views around who is/should be involved in the decision to start an MCA and why (social influences; role; beliefs about capabilities). Health professionals thought it important that residents and carers knew what/why medicines were prescribed (knowledge; role; beliefs about consequences). Some residents asserted their independence (beliefs about capabilities). Prescription changes were challenging to implement (nature of the behaviour; knowledge; skills). While MCAs were viewed as desirable (emotions; reinforcement; beliefs about consequences) few were aware of the implications for pharmacy (environmental; emotions).
This study captured multiple perspectives from residents and carers reliance, GPs lack of alternatives and pharmacists empathy. With an increasingly aged, multi-morbid population dependent on polypharmacy the pressure on pharmacy to meet the burgeoning demand for MCAs has overtaken their supply capacity.
MacLure K, MacLeod J, Forbes-McKay K, Paudyal V, Cunningham S, Strath A, Lynch R, Stewart D. A Case Study Investigation into the Use of Multi-compartment Compliance Aids in Older People Resident in Very Sheltered Housing. The Patient - Patient-Centered Outcomes Research 2016;9(6):583–590. doi:10.1007/s40271-016-0178-8