School of Pharmacy and Life Sciences, Robert Gordon University, The Sir Ian Wood Building, Garthdee Road, Aberdeen, AB10 7GJ, UK.
Aberdeen City Health & Social Care Partnership, Summerfield House, Eday Rd, Aberdeen, AB15 6RE, UK.
Res Social Adm Pharm. 2018 Apr;14(4):347-355. doi: 10.1016/j.sapharm.2017.04.004. Epub 2017 Apr 9.
Multi-compartment compliance aids (MCAs) are repackaging systems for solid dosage form medicines. Acknowledging the lack of evidence that MCAs improve adherence or clinical outcomes, the Royal Pharmaceutical Society has expressed concern that MCAs have 'become regarded as a panacea for medicines use'.
To determine the behaviors and experiences of the community pharmacy team around MCA provision.
A cross-sectional survey was conducted in 26 community pharmacies in the north east of Scotland. Survey items were grouped into: current activities in the provision of MCAs; potential influences on these activities; reports of patient experiences; and demographics. Data were analysed using descriptive and inferential statistics, and content analysis of responses to open questions. Principal component analysis (PCA) was performed on the items of potential influences on activities.
Data were collected from 136 community team members (median 4, range1-10 per pharmacy; 32.3% pharmacists). All were involved in some aspect of MCA provision and within the same pharmacy, several different staff positions were commonly involved in the same activity. PCA gave seven components; the lowest scores were obtained for the component of 'others expecting me to provide MCAs'. Participants agreed that GPs, patients and their families, and carers expected them to provide MCAs. Positive experiences of MCA provision were in themes of promoting patient adherence, reducing patient stress and enhancing patient monitoring. Further negative experiences were in of lack of shared patient decision making, worsening adherence and generation of medicines waste, and dealing with changing medicines. MCAs were not always considered to be the most appropriate solution.
While community pharmacy teams value MCAs, there may be issues around staff assignment to particular roles, expectations from others and reports of negative patient experiences. A systematic approach to MCA provision and monitoring involving the multidisciplinary health and social care team is warranted.
多腔室顺应性辅助器具（MCAs）是固体剂型药物的重新包装系统。鉴于缺乏证据表明 MCAs 能提高依从性或临床结果，皇家药学会表示担心，MCAs 已经“被视为药物使用的万能药”。
确定社区药剂师团队在 MCA 供应方面的行为和经验。
在苏格兰东北部的 26 家社区药房进行了横断面调查。调查项目分为：MCA 供应的当前活动；对这些活动的潜在影响；患者体验报告；以及人口统计学信息。使用描述性和推断性统计以及对开放问题的内容分析来分析数据。对潜在活动影响因素的项目进行主成分分析（PCA）。
从 136 名社区团队成员（每家药店中位数为 4 名，范围为 1-10 名；32.3%为药剂师）处收集了数据。所有人都参与了 MCA 供应的某些方面，并且在同一药店内，几个不同的职位通常共同参与同一活动。PCA 得出了七个组成部分；得分最低的是“其他人期望我提供 MCA”这一组成部分。参与者一致认为，全科医生、患者及其家属和护理人员期望他们提供 MCA。MCA 供应的积极体验主要集中在促进患者依从性、减轻患者压力和加强患者监测方面。进一步的负面体验则在于缺乏共同的患者决策、导致依从性恶化和产生药物浪费，以及处理不断变化的药物问题。MCA 并不总是被认为是最合适的解决方案。
虽然社区药剂师团队重视 MCA，但在员工分配给特定角色、来自他人的期望以及负面患者体验报告方面可能存在问题。需要涉及多学科的医疗和社会保健团队的系统 MCA 供应和监测方法。
